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Epistaxis (nosebleed)
A nosebleed, or epistaxis, is a common problem. Most nosebleeds relate, in some way, to trauma . Besides injury, irritation and dryness to the nasal mucosa can result in bleeding. High blood pressure and blood clotting abnormalities (which may be secondary to use of blood thinners) can also result in epistaxis. Most nosebleeds occur in the front part of the nasal septum which divides the two sides of the nose. This relatively thin structure is rich in capillaries that may rupture at times with seemingly minor provocation. Dryness and "colds" can lead to erosion of the mucosa and bleeding. If this is the case, mild saline (salt water) nasal sprays (e.g. Ocean nasal spray) four times a day on each side may be beneficial. A quarter of a teaspoon of salt in one cup of water will work fine for those who want to mix their own nasal spray. In most cases, nasal bleeding can be controlled easily with a firm 15 minute nose pinch (include the soft bulb of the nose). Additional help can be found from a decongestant nasal spray which causes the blood vessels to constrict. At times, saturating a cotton ball with the nasal decongestant spray and placing the ball in the bleeding side of the nose may be helpful along with pinching. Those with a history for high blood pressure are cautioned against the use of nasal decongestant sprays that can raise blood pressure.
This can be an even greater problem if the bleeding is secondary to extremely high blood pressure. It is important not to pick, rub, or blow your nose after the bleeding has stopped. Most patients want to clear the dried blood from their nose, but many times this is the reason the bleeding stopped. Avoid hot liquids. Aspirin and smoking can also promote bleeding. If the bleeding cannot be controlled, your doctor may need to remove all the clots from your nose and apply a nasal packing (using a topical anesthetic) to stop the bleeding. The nasal pack may be left in for 1-2 days before removal. If you have a history for high blood pressure additional emphasis will be placed on making sure your blood pressure is under control. If you are currently taking blood thinning medications (Coumadin), your blood coagulation (PT and PTT) will be checked to make sure you are not "over anticoagulated". An ENT specialist is helpful in the treatment and evaluation of recurrent nosebleeds.
Hope this article will provide you information about epistaxis.
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