Causes of frequent nosebleeds in adults

A sneeze or a strong cleansing of the nose may be enough to break the small veins in the nose. The probability of nosebleeds is higher if the nasal mucosa is irritated, for example, from overheated or conditioned air, allergies, or decongestant nasal sprays.

A blow or fall on the nose can also cause nosebleeds. The same is possible when young children place a foreign body in their nostrils, such as peas or a small stone, lego: if the mucous membrane of the nose is damaged, blood flows. The same thing can happen while picking your nose.

In some people, an opening in the nasal septum (perforation of the septum) causes frequent nosebleeds. Such an opening may be the result of surgery in the nose. However, it can also be caused, for example, by a vascular disease, accident or inhalation of aggressive substances.

Some malformations of the nasal septum can also cause nosebleeds, while protruding spurs or bone ridges damage the nasal mucosa. Often such malformations are accompanied by a curvature of the nasal septum (deviation of the septum).

Repeated nosebleeds rarely cause a benign or malignant tumor in the nasal cavity or paranasal sinuses.

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Local causes may also explain why nasal bleeding often occurs in a teenager, child, or adult.

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Consequence of injuries

This is a very common reason, because very often in an adult, blood flows constantly after accidents, bruises, injuries at home, falls that lead to cartilage tissue fractures. As a rule, in addition to bleeding, in this case, pain and swelling of the surrounding tissues are noted. If there is blood due to a fracture of the facial bones or cartilage, then deformation will be noticeable.

Also, injuries of the nasal mucosa occur if specific operations are performed, manipulations for diagnosis: probing, puncture or catheterization of the sinuses.

ENT diseases

If local pathological conditions develop, plethora of the nasal mucosa may be noted. This can be observed with sinusitis, adenoids, sinusitis. Also, such manifestations are possible in people with chronic rhinitis (allergic, etc.), especially if they are used to very often and uncontrollably use drops in the nose, which constrict the blood vessels. Also dangerous in this case are hormonal drugs that provoke thinning of the nasal mucosa and, as a result, its atrophy.

In patients with atrophic rhinitis, dystrophic changes in the mucosa are noted, which leads to the manifestation of nosebleeds. Anomalies in the development of arteries and veins (their local expansion), severe curvature of the septum of the nose, or the location of the vessels of the mucous membrane too close to the surface can also lead to bleeding.

Sometimes frequent bleeding in women and men is a sign that a benign or malignant formation develops in the nasal passages. It can be polyps, adenoids, tumors, angioma, specific granuloma.

Often, the causes of blood from a child’s nose are associated with injuries by various objects – a finger, toys, etc. Sometimes blood flows if small foreign objects, small insects disappear into the nose. It flows sometimes even after a child has been bought in an open reservoir, since parasites – ticks, etc. can get into the nasal cavity.

Sometimes an explanation of why the baby’s nose comes from the nose at night or in the morning is a helminthic invasion, since ascaris larvae migrate into the lungs, nasopharynx, and other organs and damage vessels. Therefore, if the baby’s nose often bleeds, you need to check for parasites in the body.

In any case, if the child goes bleeding, it is necessary to act correctly, as advised by Dr. Komarovsky and other specialists. How emergency care is carried out for nosebleeds in children, how to stop bleeding, can be found below.

Causes and possible diseases

Epistaxis occurs when the thin vessels of the nasal mucosa with high perfusion are damaged. Venous vessels are mainly affected, a sign of this is that the outgoing blood is dark red. With arterial injuries, bleeding is bright red and throbbing.

Note. In rare cases, severe bleeding of the esophagus occurs from the mouth and nose (for example, local varicose veins – esophageal varicose veins), which mimics nosebleeds.

Since several blood vessels (med. Locus Kiesselbachi) converge in the front of the nose, most of the bleeding occurs there. They are usually harmless.

Dangerous nosebleeds often occur in the back of the nose. This is due to the fact that in the posterior parts of the nose, the supply vessels are not as well branched as in the front, so there is more blood loss. This type of nosebleed often requires medical intervention to stop the bleeding.

It is also necessary to distinguish between bleeding from the nose whether the cause is local (in the nose), or caused by another disease (outside the nose). The first option is more common.

Symptoms, signs of anterior and posterior bleeding

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Symptoms of nosebleeds, in addition to the fact of blood flow, can be supplemented by symptoms of the underlying disease and signs of acute blood loss:

  • noise in ears
  • dizziness
  • tachycardia (palpitations), shortness of breath
  • lowering blood pressure
  • itchy nose, tickling
  • headache
  • general weakness
  • pallor of the skin (slight)

With low bleeding, symptoms of blood loss usually do not occur. Blood flow can be both outward and inward. When blood enters the back wall of the oropharynx, it does not go outside; it can be detected by pharyngoscopy. With severe blood loss, hemorrhagic shock can develop – a filiform pulse, a sharp drop in pressure, tachycardia.

  • In the anterior – the source in 90% of cases is the Kisselbach zone, an extensive network of small blood vessels that are covered with a fairly thin mucous membrane, almost without a submucosal layer. With such bleeding, there is usually no severe blood loss, it stops on its own and does not threaten a person’s life.
  • In the posterior, large vessels in the deep sections of the nasal cavity are damaged, it is dangerous for the patient and almost never stops on their own.

To determine whether the bleeding is front or back, the doctor examines the patient, anterior rhinoscopy and pharyngoscopy are performed.

  • With gastric and pulmonary bleeding, blood can flow into the nasal cavity and mimic the nasal – this will be seen by the doctor when examining the patient.
  • With pulmonary – the blood foams and is bright scarlet, with a nasal dark red, with a gastric one it is very dark, similar to coffee grounds.
  • With intense nosebleeds running down the back wall, vomiting with dark blood may occur.

To find out what is the main cause of nosebleeds, a general examination and clarification of the symptoms of the underlying disease is required. To assess blood loss, it is necessary to pass a coagulogram and a general blood test.

Epistaxis occurs due to rupture of one or more vessels in the mucous membranes of the nose. Blood appears in the form of large drops or a thin stream. A person’s condition may not signal any impending bleeding.

Symptoms and signs of impending bleeding in each person are different. The dynamics of deterioration of the general condition is mainly observed. Patients feel a sharp ringing in the ears, an unpleasant burning sensation or itching in the nose.

The symptomatology of these processes is diverse and depends on localization.

  • The front epistaxis is manifested by leakage of a stream from one half of the nose or from two at the same time. Such bleeding begins spontaneously, without previous factors, more often happens at night. Sometimes, before its onset, weakness and dizziness are felt. Blood is bright red, without clots. Such bleeding may stop on its own.
  • The posterior usually begins without obvious symptoms and is more often determined after some time. With this localization of the source of bleeding, blood flows into the abdominal cavity through the pharynx along its posterior wall. This process usually occurs with hemoptysis, bloody vomiting, and later “black” bloody stools appear. Symptoms of the ongoing condition are marked pallor of the skin, increasing weakness, the appearance of a “filiform” pulse and even the onset of fainting. In this situation, immediate medical attention is needed.

Signs of epistaxis sometimes complement the symptoms of the underlying disease, as well as symptoms of acute blood loss. It is necessary to pay attention to such manifestations:

  • dizziness;
  • noise in ears;
  • lowering blood pressure;
  • tachycardia and shortness of breath;
  • pallor of the skin;
  • tickling and itching in the nose;
  • headache ;
  • feeling of weakness.

If there is little bleeding, then signs of blood loss are usually not pronounced. Blood flow can occur both inward and outward. If it does not go out and flows along the posterior wall of the oropharynx, then it can be detected by pharyngoscopy. If significant blood loss has occurred, a person may experience hemorrhagic shock, in which there is a sharp decrease in pressure, a threadlike pulse, and tachycardia.

Bleeding is of the following types: anterior and posterior.

If anterior bleeding occurs, in most cases (approximately 90%) its source is the Kisselbach zone. In this zone, there is a large network of small vessels covered with a thin mucosa with almost no submucosal layer.

In such a situation, blood loss is usually mild. It stops on its own – elementary first aid for bleeding from the nose acts almost immediately. Such a phenomenon is not life threatening.

If back bleeding develops, large vessels that are located deep in the nasal cavity are damaged. This is a dangerous condition for the patient, because the blood itself stops very rarely.

The doctor can determine the type of bleeding by examining the patient, having performed pharyngoscopy and anterior rhinoscopy.

In addition, during the examination, the doctor can determine the development of pulmonary or gastric bleeding, since in such conditions the blood sometimes flows into the nasal cavity. Recognizing pulmonary hemorrhage is not difficult – in such a situation, the color of the blood is bright red, it foams. If the stomach is dark, it resembles coffee grounds.

In the case of very intense bleeding that flows down the back wall, vomiting may develop in which dark impurities are noted.

To find out why bloody discharge from the nose appears, a general examination will help to diagnose the underlying disease.

To assess blood loss, the doctor prescribes a coagulogram, as well as a general blood test.

Epistaxis: Systemic Causes

Epistaxis can be a sign of a serious illness. For example, the following diseases can cause nosebleeds:

  • febrile illnesses such as flu or measles (bleeding from edematous mucous membranes is easier to cause);
  • a cold (an inflamed mucous membrane of the nose can easily begin to bleed, especially if you often sneeze);
  • kidney disease;
  • vascular and cardiovascular diseases such as arteriosclerosis and high blood pressure (hypertension);
  • congenital platelet dysfunction (thrombocytopathy);
  • various autoimmune and hereditary diseases, such as Wegener’s disease, Osler’s disease, hemophilia (for example, hemophilia A and B, von Willebrand syndrome, etc.) 4
  • leukemia (“blood cancer”).

In some cases, nosebleeds are triggered by drugs. This applies, for example, to the so-called antiplatelet agents. These drugs inhibit platelet adhesion, preventing blood clotting. This increases the tendency to bleed, such as nosebleeds or bleeding gums. A well-known representative of platelet aggregation inhibitors is acetylsalicylic acid (ASA).

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So-called coumarin derivatives can cause nosebleeds: these active ingredients lower the level of vitamin K in the body, which impairs blood coagulation. This is usually done deliberately – coumarins (such as fenprocoumone, warfarin) are prescribed for patients who can easily form clots that clog vessels. These include, for example, people with atrial fibrillation. Coumarin use can reduce the risk of heart attack and stroke.

Other drugs that can cause nosebleeds include some antibiotics and psychotropic drugs.

First aid for epistaxis

You need to clearly understand what to do with nosebleeds to help both yourself and the child if severe bleeding develops. It is especially important to know how to stop nosebleeds for parents. Indeed, this often happens with children.

  • If spotting is noticed in a child or in an adult, you must immediately give him a reclining position – put the patient, tilt his head forward. You can also apply cold for a few minutes on the bridge of the nose – for example, ice wrapped in a towel or a heating pad with cold water.
  • You can also instill vasoconstrictor drops in your nose (it can be Naphtizin, Nazivin, Galazolin) or 3% hydrogen peroxide, and then pinch your nostrils with your fingers.
  • If it flows and does not stop from the nose, these same drops or hydrogen peroxide should be applied to a cotton swab and inserted into the nostril, pressed to the septum.
  • Provided that it flows from the right nostril, a person needs to raise his right hand, and press the nostril with his left. If there is bleeding from both, the person should raise both hands, and the one who helps him can press both nostrils.
  • If no advice on how to stop nosebleeds quickly, is ineffective, you must definitely call an emergency. It is the doctor who must determine how to stop the blood from the nose, if it flows non-stop, despite all the measures taken.

After the discharge from the nasal cavity has stopped, you do not need to pull out the swab too sharply, as there is a risk of damage to the blood clot, after which the attack may recur. It is better to carefully moisten the swab with hydrogen peroxide, wait until it softens, and only then pull it out.

If even such a case occurred once, it is necessary to take the child to the otolaryngologist to determine the cause of this phenomenon. The doctor will tell you what diseases there are that provoke such a symptom, and prescribe studies to determine the diagnosis and prevent relapse.

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To prevent a baby’s dry nose, blood crusts, speed up the healing process and reduce the likelihood of relapse, you should lubricate the mucous membrane with Bacitracin, Neomycin or Vaseline ointment twice a day. During the heating season, you can instill in your nose funds based on sea water (Salin, Aqua Maris).

In severe cases, when it is not possible to cope with the situation on their own, experts anemize the mucosa with a solution of epinephrine or ephedrine. If the front tamponade is ineffective, the posterior tamponade is performed. However, in most cases, both in children and in older people, anterior tamponade helps with posterior bleeding.

If relapses occur very often or tamponade is ineffective, surgical intervention is necessary. For people who are concerned about the frequent manifestation of anterior bleeding, coagulation and endoscopic cryodestruction will be effective methods. Also in such a situation, sclerotizing drugs are sometimes administered, drugs that increase blood coagulation are prescribed.

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Sometimes, if a person has weak vessels or suffers from other diseases, you should not wait until the bleeding stops – you need to immediately call for emergency help so that the doctor helps the patient. This is necessary if the following occurs:

  • blood pressure rises;
  • there was a nose injury;
  • the patient has diabetes;
  • the person has fainted;
  • very severe bleeding was noted, in which there is a threat of great blood loss;
  • if for a long time a person has been taking or is currently taking Heparin, NSAIDs, Aspirin, or the patient has problems with blood coagulation;
  • if vomiting with blood is noted, which may indicate damage to the stomach, esophagus, lungs;
  • if along with blood secretions a clear fluid flows in a person after a head injury – this may indicate a fracture of the base of the skull.

If an adult or a child has severe bleeding from the nasal cavity, he will be hospitalized in the inpatient department. Even if you managed to cope with the problem yourself, then you need to consult with the otolaryngologist later.

If the cause of the problem cannot be detected, and such manifestations are constantly manifested, you need to be examined by a number of specialists – an endocrinologist, hematologist, neurologist.

If blood appears from the Kisselbach zone, then this area is burned to prevent relapse. If necessary, the otolaryngologist practices the following measures:

  • removes polyps or a foreign body from the nasal cavity;
  • conducts anterior or posterior tamponade, which is impregnated with a 1% solution of feracryl, canned amnion, epsilon-aminocaproic acid;
  • in order to cauterize the vessel, a tampon with trichloroacetic acid and vagotil is introduced;
  • practices coagulation using electric current, silver nitrate, laser, ultrasound, liquid nitrogen, or conducts cryodestruction;
  • uses a hemostatic sponge;
  • introduces sclerosing drugs, an oily solution of vitamin A;
  • if the blood loss is very serious, the doctor uses freshly frozen plasma, a blood transfusion, administers hemodesis, reopoliglyukin and aminocaproic acid intravenously.

If all these methods are ineffective, then they perform a surgical operation – embolization of large vessels in the area of ​​the nasal cavity where problems are noted.

Drugs that increase blood coagulability are also prescribed – these are calcium chloride, vitamin C, Vikasol, calcium gluconate.

If nosebleeds have occurred, you should not eat hot food and drink hot drinks after that, do not practice serious physical exertion in order to prevent the reappearance of this problem.

  • To give an adult or child a semi-recumbent position, it is best to put a person and tilt his head forward.
  • Apply cold on nose bridge for 10 minutes.
  • You can instill vasoconstrictor drops (galazolin, naphthyzine, nazivin, etc.), in their absence 3% hydrogen peroxide, pinch your nostrils with your fingers.
  • If this does not help, then apply drops (or a weak solution of hydrogen peroxide) on a cotton swab (ball) and insert it into the nostril, pressing it to the nasal septum.
  • If blood flows from the nose from the right nostril – raise the right hand up, while holding the nostril with the left, if from both, then the patient raises both hands up, and the assisting person presses both nostrils.
  • If these activities do not help after 15-20 minutes, then you should call an ambulance.

After the bleeding stops, you can’t drastically pull out the swab, because you can damage the blood clot and the nose will bleed again. It will be correct to moisten it with hydrogen peroxide before removing the tampon and only then remove it.

Even after a lump-sum episode, especially in a child, one should consult an ENT doctor to find out a possible cause and prevent relapse. To prevent drying out, accelerate healing and reduce the risk of repeated bleeding, you can lubricate the nasal mucosa with Vaseline (Neomycin ointment, Bacitracin) 2 r/day, if the apartment has dry air (heating season), the child can be dosed with seawater – Aquamaris, Salin.

If it is not possible to stop the blood on their own, doctors can anemize the nasal mucosa with a solution of ephedrine or adrenaline. If bleeding does not stop after anterior tamponade, then the posterior tamponade is performed. But usually the front tamponade also helps with posterior nosebleeds.

With often recurrent discharge of blood from the nose or with the inefficiency of tamponade, surgical treatment is performed. With frequent anterior hemorrhages, endoscopic cryodestruction, coagulation (cauterization) is used, as well as the introduction of sclerosing drugs, etc.

In the cases listed below, you should not waste time and wait for a spontaneous stop of bleeding, and you should immediately call an ambulance:

    high blood pressure (blood pressure)

Back tamponade
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Adults and children with severe bleeding and significant blood loss are hospitalized in the hospital, in the ENT department. If at home it was possible to quickly stop him, then anyway the child should be shown to the otolaryngologist and the adult should also consult a doctor. With frequent nosebleeds in children and adults, when it is not possible to detect an obvious reason, a hematologist, endocrinologist, and neurologist should undergo an examination.

Most often, blood flows from the Kisselbach zone, in order to prevent new cases, this place is cauterized. An ENT doctor can do the following:

  • remove polyps, foreign body
  • back or front tamponade soaked in 1% solution of feracryl, epsilon-aminocaproic acid, canned amnion
  • insert a swab with vagotil or trichloroacetic acid to cauterize the vessel
  • coagulation using one of the modern methods: electric current, laser, ultrasound, silver nitrate, liquid nitrogen, chromic acid, or endoscopic cryodestruction
  • possible the introduction of an oily solution of vitamin A, sclerosing drugs
  • use a hemostatic sponge
  • with severe blood loss, the use of freshly frozen plasma, transfusion of donated blood, intravenous administration of hemodesis, reopoliglyukin and aminocaproic acid is indicated
  • if the above methods did not have an effect, surgical intervention is possible – embolization of large vessels (ligation) in the problem area of ​​the nasal cavity
  • the purpose of blood clotting drugs is vitamin C, calcium chloride, calcium gluconate, Vikasol.

After nosebleeds, it is not advisable to use hot dishes and drinks, you can not play sports for several days, since this contributes to a rush of blood to the head and can provoke a second.

Causes in children

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The causes of nosebleeds in children are divided into:

The first item refers to the anatomical feature of the vascular network. Inflammatory processes provoke the release of mucus in the nasal cavity, it dries up under the influence of dry air, crusts appear, which the child sometimes tries to remove on his own and injures the nasal cavity.

The child is trying to remove dried crusts from the nose, thereby injuring the nasal cavity

With a strong cough, sneezing in combination with a dry mucous membrane, strong pressure can occur, which will lead to the appearance of blood. If the baby fell and hit his nose or stuffed something into it, the reason is obvious. The occurrence of bleeding without damage can indicate serious violations in the body.

In the anterior section of the nasal septum there is a fairly tender area, where many capillaries are located. It is from this part of the nose that nose bleeds in children occur in 90% of cases. Such nosebleeds are harmless and can be stopped quite quickly.

Sometimes a child can bleed from large vessels of the nose. In such cases, a fairly strong and intense bleeding occurs. Therefore, it is urgent to call a doctor to help with nosebleeds.

It happens that a child has blood flowing from the nose, but other organs are a source of bleeding – the trachea, bronchi, lungs, esophagus or stomach. Therefore, it is so important to understand the cause of nosebleeds in children. With bleeding from the nose, the blood is of the usual color, it flows down the back wall of the pharynx. Very dark, the color of coffee grounds, blood can indicate bleeding from the stomach.

Fast and large blood loss is dangerous for the health and life of the child. With significant blood loss, the child may appear general weakness, dizziness, pallor of the skin, noise and ringing in the ears; dashes in front of the eyes, thirst and palpitations.

Then blood pressure decreases, the child may lose consciousness.

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When bleeding from the back of the nose, the child can swallow blood, and only by vomiting with blood clots can you understand that he has nosebleeds.

Damage to the vessels of the nasal mucosa can occur in a child in a variety of cases. Among the main causes of nosebleeds in childhood are the following:

  • injuries to the nose (fracture, bruise, damage to the nose with a foreign object stuck in it);
  • medical operations performed on the nose;
  • tumors, polyps, ulcers in the nose;
  • rhinitis, sinusitis, adenoiditis;
  • curvature of the nasal septum;
  • sun and heat stroke;
  • sudden surges in pressure;
  • intense physical activity for the child’s body;
  • lack of calcium, potassium and vitamin C;
  • low blood coagulability;
  • hormonal changes in adolescence;
  • hepatitis, liver diseases, etc.

Epistaxis in children can be due to one of the above reasons.

In young children, a foreign body or nasal cannula inserted into the nose is often the trigger for bleeding. For many older children, just a larger growth spike is the cause of nosebleeds. Small vessels in the nasal mucosa become more sensitive and rupture faster. This type of nosebleed usually stops quickly.

Epistaxis: causes in pregnant women

Nasal congestion and, sometimes, nosebleeds are not uncommon during pregnancy. The reason for this is a change in hormonal balance. The body produces more female sex hormone estrogen. This weakens the connective tissue, even in the walls of the vessel. This dilates blood vessels, which increases blood circulation – including in the nasal mucosa, which contributes to nosebleed during pregnancy. No matter how unpleasant it may be for the affected women, such bleeding, fortunately, is short-term and harmless.

What does the doctor do?

  • In the case of blood from the nasal cavity, you can not lie down or throw your head back – this will only worsen the situation, and blood in such poses can flow into the airways or into the esophagus. If it enters the respiratory tract, it suffocates, if it enters the stomach, it leads to nausea and vomiting.
  • It is also impossible to blow out oneself, as this can displace the clot that has formed.
  • If a foreign body enters the nose, do not remove it yourself – this should be done by a specialist.

Blood from the nose in an adult occurs for various reasons. Most people, feeling this ailment for the first time, panic and often make mistakes trying to stop the bleeding.

Principle of action for nosebleeds

Actions to Avoid:

  1. Plugging. Doctors do not recommend inserting pieces of cotton wool into the nose. When the blood stops and begins to dry, it will be problematic to remove the cotton.
  2. Blowing your nose Trying to blow out the remnants of blood, a person creates pressure and provokes a new attack of bleeding.
  3. Tilting the head back. With heavy bleeding is accompanied by a high risk. Blood that was supposed to escape through the nose enters the throat, then into the bronchi and causes a severe cough. Getting into the gastric cavity is fraught with further vomiting. Also in this position, the veins are squeezed, which are responsible for the outflow of blood from the head area, due to which pressure can rise.
  • Do not throw your head back and take a lying position – this increases bleeding, blood can flow into the esophagus or respiratory tract. If it enters the stomach, it will cause nausea and vomiting, if it is suffocation in the airways.
  • Do not blow your nose – this will displace the resulting clot, which can increase bleeding
  • If a foreign body enters, you cannot remove it yourself.

Bleeding, including nosebleeds, is alarming for many people. However, it’s important to stay calm! Do not give in to the reflex, throwing your head back! As a result, blood flows down the throat and esophagus into the stomach, which is harmful. In addition, it is not possible to assess how severe the bleeding is.

It is better to perform the following emergency measures for nosebleeds:

  • Take a vertical pose. You must tilt your head forward so that blood can flow freely through your nose. A bowl or rag will help to collect blood.
  • You must grip your nose tightly for a few minutes with your thumb and forefinger. Then check to see if nosebleeds have stopped. If not, squeeze your nose again for a few minutes.
  • You can cool the neck or base of the nose with a cool, damp cloth or wrapped ice cubes. As a result, afferent vessels contract, and bleeding decreases.

Caution: under no circumstances should you lie with nosebleeds. You should not put a handkerchief or cotton wool in your bleeding nose, as if you have a wound, you can, in particular, easily injure it again. Also, avoid blowing your nose immediately after nosebleeds. Otherwise, he quickly begins to bleed again.

Depending on the nature and severity of nosebleeds, the doctor will try to stop the bleeding using appropriate means/methods:

  • In case of bleeding in the anterior part of the nose (especially in the Kisselbach well), the affected area can be treated, for example, with silver nitrate, or closed (“obliterated”) with a laser or electrocoagulation.
  • An old but proven way to stop nosebleeds is with tampons. For bleeding in the front of the nose, the doctor may use self-inflating swabs or those that may be swollen. With nosebleeds from the back of the nose, the so-called Bellock tamponade is used – this is the posterior tamponade of the nose through the nasopharynx.
  • In the case of very severe nosebleeds, targeted embolic closure of the affected vessel in the nasal mucosa may be useful. The vessel is closed from the inside through a catheter under the control of special imaging methods. This method is usually performed by radiologists.
  • Occasionally, decongestant nasal sprays can help with nosebleeds. Their active ingredients, such as xylometazoline, cause blood vessels to contract.
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In addition, an ENT doctor will also check your heart rate and blood pressure. If your blood pressure drops significantly and your heart rate accelerates, this may be a sign of high blood loss. Then the doctor will try to stabilize blood circulation by introducing blood substitutes. Blood transfusion is carried out with nosebleeds only in case of emergency.

Repeated nosebleeds

If the patient repeatedly suffers from nosebleeds, the doctor will look for the cause. First, he will conduct a conversation with the patient, collecting important information about the medical history (medical history). For example, the doctor asks in which situations nosebleeds occur more often, and whether the patient has other complaints. This is followed by an examination of the nasal cavity using a rhinoscope (region of the anterior nasal cavity) or a nasal endoscope (region of the posterior nasal cavity). In addition, the following studies can help determine the cause of frequent nosebleeds:

  • Visualization Procedures. For example, with the help of an ultrasound device, the doctor can evaluate the sinuses quite well. Even more accurate images are obtained using magnetic resonance imaging (MRI), which is much more complicated. To better evaluate the bones of the skull after accidents or blows to the face, computed tomography (CT) is usually used.
  • Blood analysis. Different blood levels can provide information about possible clotting disorders or inflammation.
  • Blood pressure measurement. By measuring blood pressure, you can determine the presence of high pressure (hypertension).

Prevention of nosebleeds

Preventive measures depend on the etiology of the disease. People suffering from frequent epistaxis should first of all know the reasons for their appearance. Are they associated with a rise in pressure or not? Is there a general history of nasal bleeding? Have there been injuries to the nasal mucosa?

In order to prevent bleeding, excessive physical exertion should be avoided. It is necessary to eat properly and balanced, to consume a sufficient amount of fluid per day. Drying of air in apartments and workrooms should not be allowed, if possible use humidifiers and air ionizers.

It is very important to treat acute inflammation of the sinuses and nose in a timely manner. It is worth paying attention to the quality and shape of the pillow for sleeping, it is best to use an orthopedic model. It is undesirable to allow damage to the nasal mucosa. Periodically, you need to moisten it with oil solutions of vitamin A and E.

With frequent and seemingly unreasonable at the first glance nasal bleeding, examination by a hematologist, endocrinologist, and neurologist is mandatory. When taking medications that change blood coagulation, you should regularly monitor its performance. It is necessary to carry out annual prevention of acute respiratory viral infection, do not forget about hardening and vitamin therapy. And, of course, one of the important preventive measures is to consult a qualified ENT doctor.

  • according to indications, taking Ascorutin to strengthen the walls of blood vessels
  • humidification during the heating season
  • nutritious nutrition rich in natural vitamins and minerals
  • injury prevention.
  • Sometimes, for the purpose of prevention, Ascorutin is prescribed to children and adults, and vascular fragility is treated.
  • During the heating season, you need to properly moisten the air in the room.
  • It is important to eat fully and variably in order to get all the vitamins and minerals that are necessary for the body.
  • Avoid personal injury.

Prevent nosebleeds

There are some tips to help reduce the risk of nosebleeds. Especially people with sensitive nasal mucosa should adhere to the following:

  • Provide sufficient humidity in the apartment. Dry air is poison for the nasal mucosa. Optimum humidity is between 40 and 60 percent.
  • Regular walks in the fresh air are also good for the nose.
  • In winter, when the air becomes especially dry, and a wave of colds haunts many, it begins to use a drop in the nose and sprays. They can be used if necessary, but only for a short time, as nosebleeds can be provoked. Nasal lavage is better – it will help prevent a cold or alleviate pre-existing symptoms of a cold.
  • If you want to use nutritious sprays or ointments, you must make sure that they are suitable for the nose.
  • In case of allergies, it is recommended to avoid triggers, which, of course, is only partially possible. Although the so-called hyposensitization lasts several years, it helps a lot of allergy sufferers and reduces allergic symptoms in general.
  • A healthy diet low in fat and meat, as well as enough exercise to prevent overweight and high blood pressure and therefore vascular calcification, since atherosclerosis can contribute to nosebleeds.
  • Tobacco and alcohol consumption can contribute to nasal tumors (and many other diseases). Therefore, refrain from harmful stimulants.
  • In addition, caution should be exercised while using various drugs. For example, those who are already receiving blood thinners should not take acetylsalicylic acid (ASA) for pain, since it also has an anticoagulant effect and, therefore, the effect is cumulative – the tendency to bleed (for example, nosebleed) increases further .

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What are regular bleeding talking about?

Often occurring bleeding is by no means safe and requires urgent specialist advice. Common causes include cyst formation in the nasal cavity or systemic diseases, for example, chronic tonsillitis can also cause nosebleeds.

Chronic tonsillitis can cause nosebleeds

Causes of Pregnancy

The period of bearing a child is a series of hormonal changes. During pregnancy, estrogen and progesterone levels increase. These hormones have a side effect – excessive filling of blood vessels with blood vessels.

Symptoms are easy to track:

  • swelling and friability of the inner lining of the nose;
  • dry mucosa;
  • fragility of blood vessels and, as a result, blood from the nose.

These reasons include:

  • increased blood pressure – it is dangerous for both the mother and the unborn child, since the blood circulation of the placenta is disturbed, which is fraught with oxygen starvation for the fetus;
  • lack of vitamin and minerals (calcium and vitamin K);
  • severe rhinitis, after which there are changes in the mucous membranes of the nose.

Stop methods

Treatment of nosebleeds should begin with the diagnosis of diseases and pathological processes that led to the development of this symptom.

1 129 - Causes of frequent nosebleeds in adultsFirst aid for nosebleeds

Depending on the type of bleeding, its profusion and duration, therapeutic measures are selected to eliminate it.

Self-help measures, or until medical bleeding stopsMedical therapeutic methods to stop bleeding
1. It is necessary to adopt a semi-sitting posture. Feet should be lowered. This position will reduce stress in the vessels of the brain.

2. The head should be turned in the opposite direction from the sinus with which the blood flows.

3. Throwing your head back during nosebleeds is strictly prohibited. In this position of the head, blood can begin to flow into the respiratory passages.

4. Insert a cotton or gauze swab into the bleeding nostril, which must be moistened in a solution of hydrogen peroxide.

1. The implementation of therapeutic measures, which are indicated in self-help measures.

2. Tamponade of the front of the sinus, which involves the deep introduction of a gauze or cotton swab into the sinus.

3. Burning of the mucous membranes of the nose.

4. Tamponade of the back walls. A rather complicated procedure, which involves the introduction of a gauze swab in both sinuses.

5. A complete physical examination, passing all the necessary tests to diagnose the root cause that caused the bleeding.

6. The introduction of drugs that stop bleeding, and strengthen the walls of blood vessels.

7. Measures aimed at stabilizing pressure indicators (if there are signs of a constant increase).

Bleeding from the nasal sinuses in a child and an adult can be both a relatively normal condition caused by the physiological characteristics of the body and also indicate serious diseases of the internal organs and circulatory system.

With constant bleeding from the nose, it is necessary to undergo a complete medical examination, and identify the cause of its appearance. But to search for the causes of nosebleeds is necessary only when it was stopped, and with its regular repetition.

If the bleeding is profuse and often recurring, there is reason to contact a hematologist who will prescribe treatment and a list of drugs. They can be used to reduce blood loss.

The list includes the following drugs:

  1. Hemostatic tube – the use of the drug is recommended to stop severe bleeding (from the gums or nose). The composition includes: blood plasma of cattle or humans, calcium chloride and thromboplastin. In combination, these components are capable of exerting a hemostatic effect. A hemostatic tube is used, observing the following sterile conditions: it is necessary to dry the nasal cavity with a gauze swab in advance and place a piece of sponge inside. After a day, remove the formed fibrin film. The remaining particles of the sponge will resolve within a month.
  2. Aminocaproic acid is a general and local drug. The release form is a translucent white powder that dissolves well in water. No taste or smell. The drug stops bleeding, reduces fibrinolytic activity and is used for heavy blood loss.
  3. Dietion (etamsylate) – is available in the form of tablets (0,25 mg.) And ampoules (2 ml.). It is prescribed by a doctor to eliminate capillary bleeding. Also used for prevention. The drug improves the function of platelet activity and lowers capillary permeability.
  4. Contrical is a powder for the preparation of a solution for intravenous administration. It is prescribed for nosebleeds of an abundant nature, mainly arising from injuries. The drug reduces the risk of blood clots.
  5. Rutin (vitamin P) is a general strengthening drug whose action prevents capillary fragility. It is produced in single-component preparations and as part of Ascorutin tablets (in combination with ascorbic acid).
  6. Thrombin is a potent drug that is taken under the supervision of a physician. Able to stop blood in a short time. It is used for various bleeding. The drug is available in the form of a loose mass of light pink color, diluted with saline. Used in the form of lotions or tampons moistened with a solution to stop bleeding.

Diagnostic methods for bleeding causes

Correct diagnosis helps to localize the process, find out its cause and choose the optimal treatment method. Such events are carried out only in the office of an otorhinolaryngologist and usually consist of several stages.

Analysis of patient history and complaints:

  • when did the first complaints appear?
  • Was a nose injury preceded?
  • is there a history of concomitant diseases?

General inspection includes:

  • determination of the condition of the skin and mucous membranes;
  • measurement of heart rate and pressure indicators.
  • investigation of the nose and location of a local process;
  • determines whether blood flows from one nostril or through both nasal passages;
  • assesses the condition of the mucous surface of the pharynx;
  • reflects the amount of blood loss and the functioning of the blood coagulation system;
  • the amount of iron in the serum helps to assess the degree of possible anemia.

Diagnosis of nosebleeds in adults and children is carried out using an external examination, examination of the nasal cavity, nasopharynx and pharynx. Sometimes it is necessary to differentiate nasal bleeding in adults and children from bleeding originating from other organs – the lungs, esophagus or stomach. In such cases, blood enters the nasal cavity and then flows out of the nostrils. It is necessary to be examined by other specialists and identify the cause.

Specialists of more than 30 specialties are taking part in MedicCity. You can make an appointment with them at any time convenient for you.

To determine the exact causes of the appearance of blood from the nose in an adult, the following diagnostic methods are used and prescribed:

  1. Rhinoscopy, endoscopy of the nose. Allows you to determine the external causes of the appearance of blood (injury or polyp rupture).
  2. Clinical analyzes of blood biochemistry. They help to identify problems in the hemodynamics and hemostatic blood system, if any.

Rhinoscopy helps determine the external causes of bleeding

Based on the general and clinical data, the doctor will identify a disease that provokes nosebleeds. A correctly diagnosed and determining the cause of the appearance of blood from the nose in an adult will help you choose the right treatment and permanently get rid of an unpleasant problem.

Tatyana Jakowenko

Editor-in-chief of the Detonic online magazine, cardiologist Yakovenko-Plahotnaya Tatyana. Author of more than 950 scientific articles, including in foreign medical journals. He has been working as a cardiologist in a clinical hospital for over 12 years. He owns modern methods of diagnosis and treatment of cardiovascular diseases and implements them in his professional activities. For example, it uses methods of resuscitation of the heart, decoding of ECG, functional tests, cyclic ergometry and knows echocardiography very well.

For 10 years, she has been an active participant in numerous medical symposia and workshops for doctors - families, therapists and cardiologists. He has many publications on a healthy lifestyle, diagnosis and treatment of heart and vascular diseases.

He regularly monitors new publications of European and American cardiology journals, writes scientific articles, prepares reports at scientific conferences and participates in European cardiology congresses.