My 8-year-old son has frequent bleeding from nose. What is the cause?

Hi,

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I have gone through the sent picture (attachment removed to protect patient identity). The polyp like structure present in the right nostril is the inferior turbinate of the right side. It is a normal structure and it appears blue due to bleeding or allergies. In an eight years old child, bleeding can occur due to repeating pricking of the nose and allergies. Both of these conditions can cause crust formation inside the nose and when the crust comes off, then they result in bleeding at that site. This cycle repeats and the mucosa never heals itself completely. Climatic conditions and changes in atmospheric conditions can also play an important role. When we see patients like this, we examine the nose using an endoscope. We do all the routine blood tests to know the reason for having a bleeding tendency in the child. We do tests such as hemoglobin, total cell count, iron indices, bleeding and clotting time, prothrombin time, activated thromboplastin time, fibrin degradation product, and platelet count. Please mention whether you have done any of these investigations. Please mention whether your child has allergies or whether he rubs his nose or eyes repeatedly, and any runny nasal discharge. Please answer these questions to help you.

Hi,

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The bleeding can occur due to rhinitis with associated dryness. As I mentioned, the secretions dry up inside the nasal cavities and cause crusts. These crusts usually get dislodged with air currents and it strips off from the mucosa. The oozed out blood clots form crusts again and the cycle continues again. If you have reached me, I would have checked the inside of the nasal cavities to rule out any obvious mass or lesion. Then, I would have given a conservative treatment for this problem. I advise you use Soframycin or Neomycin ointment inside the nasal cavities thrice daily for two weeks. This should be preceded by saline nasal douching or saline nasal sprays can be used. You can use two or three puffs in each nasal cavity twice or thrice daily for two weeks. Resist from blowing nose forcefully. When there is sneezing or coughing, do it with an open mouth as much as possible. Take steam inhalation twice or thrice daily. When there is bleeding, pinch the nose thoroughly for five minutes and keep ice packs on either side of the nose. Avoid doing strenuous work exercise like running, jogging and playing for a couple of weeks till the problem get resolved. Avoid dry weather and inhaling cold air. Keep the body warm and drink plenty of water. Keep the room moist and humidified. If he becomes completely fine by following these measures, then you need not worry. But a baseline blood evaluation has to be done to take a decisive diagnosis.