What is a nosebleed?

The medical term for a nosebleed is epistaxis and it is defined as bleeding from a blood vessel which is located either in the front part of the nasal partition (known as the septum), or further back in the nasal cavity.

What causes it?

The blood vessels in the nose are very soft and any interference with them, however slight, can cause the nose to bleed. While it is true to say that most nosebleeds occur for no obvious reason, there are a number of factors which can contribute to frequent nose bleeding. Among them are:

  • picking the nose.
  • a head cold.
  • a blow to the nose, or other damage to the mucous membrane (lining of the nose).
  • a nasal allergy.
  • very dry mucous membranes in the nose due to a stuffy indoor atmosphere or a hot climate.
  • exposure to chemicals which may irritate the lining of the nose.
  • high blood pressure.
  • any deviation of the nasal septum (partition).
  • certain types of medication, eg. aspirin, which thins the blood, and some drugs used to treat arthritic conditions.

Rarely nose bleeds may be associated with serious underlying disease such as leukaemia or haemophilia.

Can it be avoided?

The following steps may help to avoid nosebleeds:

  • avoid damaging the tender blood vessels in the nasal canal. One of the simplest ways to do this is to avoid picking your nose.
  • if nosebleeds are occurring very frequently they may be a symptom of some underlying condition. In this case, medical advice should always be sought.
  • the use of a humidifier in a dry, stuffy atmosphere, or at high altitude, has been found to reduce the drying-out process of the mucous membranes in the nose.

Self-help for nosebleeds

Sit in an upright position and keep your head bent well forward. Hold the tip of your nose in a pincer-like grip for five minutes while breathing through your mouth. Applying an ice-pack to the nose may also be beneficial. If the nosebleed stops and then returns, hold the nose for between eight and 10 minutes to give the blood a chance to clot.

How do I know if the bleeding is severe?

A normal nosebleed should last no longer than a few minutes and should cause no unpleasant side-effects whatsoever. Medical attention is not usually required but you should attend your doctor if the following occur:

  • a heavy loss of blood.
  • heart palpitations.
  • shortness of breath.
  • a pale colour to the skin.
  • swallowing large amounts of blood, which may lead to nausea and vomiting.

How is heavy bleeding treated?

If the bleeding fails to stop by external pressure the nostrils may need to be packed with cotton gauze. The gauze is usually impregnated with a small amount of adrenaline. The adrenaline reduces the diameter of the blood vessels in the nose thereby reducing the amount of blood loss. Occasionally referral to a specialist may be needed in order to undergo cautery. This procedure repairs the leaking point in the blood vessel through which the blood is lost.

Some good advice

If you have suffered from a nosebleed, however slight, try to avoid blowing the nose for the next 12 hours as this will help the dried blood to stay in place and may prevent a second nosebleed.

Try not to swallow any blood as it will make you feel nauseous and will probably induce a bout of vomiting.

If you suffer from nosebleeds on a very frequent basis you should seek the advice of your GP.

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