Dr. Akshay. B. K.
Otolaryngology (E.N.T)
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hi doctor,
I have had frequent nose bleeds for the past several months. It occurs around one to four times a week and sometimes multiple times in a row. What could be the reason? Please help.
Hi,
Welcome to icliniq.com.
I went through your query and understood your concern. I have reviewed your laboratory reports (attachment removed to protect the patient's identity). The reports are normal except for a mild marginal increase in cholesterol levels, which is quite normal. So the nose bleeds that you are experiencing are called epistaxis. There are multiple reasons for that. Kindly answer a few questions so I can figure out the diagnosis. 1. Do the nose bleeds appear as a continuous watery flow, or is it blood mixed with sputum? 2. Does the bleeding occur from both nostrils, or is it from one side only? 3. Do you have any history of nasal obstruction on the side of the nosebleed? 4. Do you have any history of frequent sneezing or headaches? 5. Is there a loss of smell? 6. Any history of other bleeding disorders? 7. Have you been evaluated for blood pressure? If yes, how much are the BP (blood pressure) recordings? 8. Are you under medication? Kindly follow up with the answers. Take care.
Patient's Query
Hi doctor,
Thank you for your reply. The nosebleeds are continuous watery flow. And I believe it bleeds from both nostrils. I do not have any history of nasal obstruction, frequent sneezing, headaches, or other symptoms. Also, there is no loss of smell, no history of other blood disorders, and I am not under medications. And I do not recall the exact numbers for a reference regarding my blood pressure, but I checked recently, and it was normal. Thank you.
Hi,
Welcome back to icliniq.com.
The most frequent cause of nasal bleeding is hypertension, so please get your BP (blood pressure) checked, especially when you have episodes of nosebleeds. The other frequent cause would be a deviated nasal septum with a sharp spur. Due to dryness, crusts would be formed on these spurs, and when those crusts dislodge, there will be bleeding. This is relevant in your case. Since you do not have nasal obstruction and loss of smell, there is less chance of nasal tumors. But still, getting a nasal endoscopy is always recommended. Has it been performed earlier? Then comes your minor bleeding disorders, so a few tests are recommended to screen your clotting cascade. Have BT (bleeding time), CT (clotting time), PT (pro thrombin time), APTT (activated partial thromboplastin time), and INR (international normalized ratio) tests been performed earlier? In addition, I have a few more questions, 1. Are these nosebleeds present from childhood, or have they started recently? What is the approximate duration? 2. Are you taking medications or nasal drops for the bleeds? Kindly follow up with the answers. Take care.
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Otolaryngology (E.N.T)
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