Why do I have recurring nosebleeds for over two months now?

Question

Hi doctor,

I have recurring nose bleeds for two months. Before pandemics, I had a large blood clot of 5 to 6 inches. After a week, I saw a dry blood clot again about three inches. I took an X-ray before pandemics. The doctor told me it was sinusitis. Even after taking medications, I have the same symptoms. Before a week, I was unable to move my nose as it caused a lot of pain. Please suggest a way to resolve the issue.

Answer 1

Hi,

Welcome to icliniq.com.

There are various reasons to have nose bleeding at your age. Accelerated hypertension is one of the causes. It is better to check your blood pressure every three hours. It can occur at any time suddenly. When the blood pressure shoots up, you start to have a torrential nasal bleed and you need to reach emergency soon to bring back your blood pressure normal.

You can have a coagulation disorder and it can be detected by doing a complete coagulation profile. It includes bleeding time, clotting time, international normalized ratio, prothrombin time and activated partial thromboplastin time. You can have a nose bleed due to recurrent dryness in the nasal mucosa. If there is nasal septal deviation, the nose does not produce a specific pattern of air current and they are referred to as eddy current. This leads to the formation of dryness in the nasal mucosa causing bleeding.

Crusting leads to irritation and dislodging the crust leads to bleeding. In these scenarios, it is better to correct the septum surgically. In some cases, the nasal septum lies in the midline and they are not really deviated and thus it does not require surgery. In this condition, it is necessary to keep applying nasal saline drops in the nasal mucosa.

You can have an allergy with sinusitis. In this condition, you have symptoms such as nasal obstruction, nasal discharge, pressure headaches, and a history of nasal allergy with allergic symptoms. In some cases, sinonasal polyps and recurrent infections can be a cause of bleeding. Nasal allergy and sinusitis is a separate entity and it requires proper evaluation, precaution, and long-term treatment.

A vascular lesion in the nose can be a cause of nasal bleeding. Depending on the size of the lesion, nasal obstruction can be present or absent. In all cases, it is good to do a nasal endoscopic assessment and if everything is normal, I suggest you do contrast-enhanced computed tomography of the nose and paranasal sinuses to see the area of problem, and take treatment accordingly.