What Is Epistaxis?
Epistaxis is minor bleeding from blood vessels in the nose. Since the blood vessels in the nose are very fragile, they can bleed easily on exposure to many factors. Profuse bleeding from the nose can lead to life-threatening complications.
How Prevalent Is Epistaxis?
Epistaxis is commonly seen in children between 2 to 10 years old and in older adults between 50 to 80 years. It is not uncommon for the nose to bleed in a child who has a nose-picking. One must be aware of the causes and the immediate first aid in such cases.
What Are the Causes of Epistaxis?
Bleeding from the nose is known as Epistaxis. Nasal bleeding can occur due to various reasons. In an older adult, a rise in blood pressure will usually cause bleeding from the nose. Other causes are the common cold, infections in the sinuses, weather changes, bleeding disorders, and cancers of the nose and sinuses. Adolescent males bleeding profusely should be investigated to rule out an angiofibroma tumor.
The factors that cause epistaxis or nose bleeding are broadly classified as:
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Local (fracture due to a sharp blow, nose-picking, etc.)
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General factors.
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A nosebleed generally starts just inside the nose entrance, on the middle, the harder part of the nasal septum (the wall between the two nasal cavities). Blood vessels of this region, being fragile, rupture easily and begin to bleed.
The factors that can cause nosebleeds possibly are:
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Structural or anatomical deformities like hereditary hemorrhage.
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Cocaine use.
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Vascular disorders.
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Deviated or perforated nasal septum.
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Connective tissue disease.
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Infectious disease (cold) or high blood pressure.
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Nasal sprays and prolonged usage of nasal steroids (particularly prolonged or improper use of nasal steroids).
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Vitamin C and vitamin K deficiency.
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Middle ear barotrauma due to sudden change of pressure.
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Surgery, such as functional endoscopic sinus surgery.
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Exposure to warm, dry air for prolonged periods.
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Certain drugs like aspirin, warfarin, isotretinoin, desmopressin, etc.
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In pregnancy, it is rare due to hypertension and hormonal changes.
Who Gets Epistaxis?
Infections, wounds, allergic reactions, nose picking, and anything forced into the nose can all result in nosebleeds. Children frequently experience nosebleeds, which are typically not life-threatening. The majority of people are going to come across them. Although nosebleeds can happen to anybody, they typically impact young people between two to ten, and senior citizens also have nosebleeds sometimes.
What Are the Types of Epistaxis?
The epistaxis is classified into two depending on their origin as:
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Anterior epistaxis.
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Posterior epistaxis.
Anterior Epistaxis:
Anterior epistaxis is the most commonly occurring type of nosebleed, usually involving one nostril. Anterior epistaxis is bleeding from the nose's anterior (frontal) part. The arteries that supply the anterior part of the nose and septum are called the Kiesselbach plexus. These arteries can easily be traumatized and bleed.
Posterior Epistaxis:
Posterior epistaxis refers to bleeding from the posterior part of the nasal cavity (bleeding that occurs in the back of the nose). It is less common than anterior epistaxis. The venous plexus in the posterior end of the inferior meatus in the nasal cavity is the woodruff plexus. Only about ten percent of cases of epistaxis are posterior epistaxis. Posterior epistaxis usually involves both nostrils. In these types of epistaxis, the blood can also flow backward and get swallowed or coughed up (hemoptysis).
How to Diagnose Epistaxis?
Most nosebleed cases are self-diagnosed and treated at home, especially the anterior nosebleeds. People with severe and unresolved nosebleeds to home remedies should seek medical advice. The doctor may ask for the following tests: blood tests and medical history. Often, posterior epistaxis is diagnosed only after failing to manage anterior epistaxis or noticing bleeding into the posterior pharynx or throat. It is often harder for healthcare professionals to visualize the source of posterior bleeding in a physical examination; thus, a clinician usually performs a nasal endoscopy to help identify the origin of the bleeding.
How to Manage Epistaxis?
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Depending on the cause and diagnosis of the nosebleed, treatment is prescribed. Generally, when the nosebleed starts as a home treatment, the patient is made to sit up straight, pinch the nose, and hold their head backward.
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Pouring cold water slowly overhead or keeping a wet cloth relieves the condition in most cases.
Care at Home:
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Small blood vessels in the nose that are bleeding can be helped to contract by applying a cool cloth to the area for a few minutes.
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Taking vitamins K and C helps maintain healthy blood vessels, keeping them from rupturing quickly.
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Nasal bleeding can also result from dehydration, which dries up the mucous membranes in the nose.
What to Do If You or Your Child Suddenly Start Bleeding from the Nose?
The first aid measures to be taken during a nosebleed are:
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Pinch the soft part of the nose with the thumb and index finger for five to ten minutes.
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Keep the mouth open and breathe.
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Rub ice over the bridge of the nose.
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Do not panic and reach out to the doctor for further treatment.
The doctor will examine the nose and decide on further testing and treatment based on the cause of Epistaxis. He may advise nasal endoscopy and cauterization of the blood vessel. If the bleeding is profuse, it may require nasal packing and hospitalization.
How to Prevent Epistaxis?
Here are a few tips that can be used to prevent nosebleeds:
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Keep the child upright and gently tilt their head forward slightly. Because leaning their head back can cause the blood to run down their throat. It will cause a bad taste and can make the child cough, gag, or even vomit.
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Avoid nose-picking as much as possible, and keep the fingernails short. Try not to blow nose too often, and only gently when people do, especially during winter and allergy seasons. If someone is taking cold or allergy medications, ensure that people follow the instructions in the package.
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Wear proper protective headgear if participating in any activities that can endanger the nose and head.
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Avoid excessive alcohol consumption and smoking.
How Severe are Nosebleeds?
Bleeding from the nose can be alarming, but all nosebleeds are not severe and are often treated at home. However, some should be checked by the doctor.
Can Nosebleeds Recur?
A few children may experience nosebleeds once or twice a year, but others get them more frequently. Since the lining of the nose is overly irritated, the exposed blood vessels can bleed even at the smallest instigation.
Conclusion:
A few nosebleeds that start from the back of the nose may usually involve large blood vessels, resulting in heavy bleeding that can be dangerous. This may require medical attention, mainly if the bleeding occurs after an injury or when the bleeding has not stopped even after applying 20 minutes of direct pressure to the nose. If individuals have frequent nosebleeds, consult with their doctor because this could be an early sign of other medical problems that need to be diagnosed.
