Epistaxis (Nose Bleeds)

Epistaxis, or “nosebleeds” may occur from the front of the nose (anterior epistaxis) or in the back of the nose (posterior epistaxis). Anterior nosebleeds often occur from the nasal septum and are more common. Posterior nosebleeds are often more serious and require physician attendance. While most nosebleeds stop spontaneously, some may be more serious and even life threatening.

Nosebleeds are most commonly caused by nasal dryness, allergies, infection and nose picking. Rarely, malignant and nonmalignant tumors are considered, particularly in older patients or smokers. Nosebleeds may also occur because of a variety of other conditions, including:

  • Vigorous nose blowing
  • Blood-clotting disorders that are hereditary or due to medications like aspirin and blood thinners
  • Trauma to the nose
  • Uncontrolled high-blood pressure

Often, nosebleeds can be controlled with the following steps:

  • A decongestant spray (like Afrin™ or Neo-Synephrin™) placed directly into the nose or on a cotton ball placed in nose
  • Pinch the front part of your nose together and press firmly toward the face, hold for 5-10 minutes (timed with a clock)
  • Keep head elevated higher than heart level
  • Apply ice to your nose and cheeks for 20 minutes

If these conservative measures do not work, consult a doctor, who may use a nasal pack to control the bleeding.

If the methods listed above to not control the bleeding, you should contact your doctor or report to the emergency room as soon as possible. Go to the emergency room if you experience the following:

  • Feeling faint or lightheaded from the bleeding
  • The bleeding is rapid and excessive
  • If bleeding begins to go down the back of the throat

Nasal packs may be uncomfortable at first because you will be forced to breath through your mouth, which can cause dry mouth. This may also temporarily impair your sense of smell and taste.

You may experience some thin, bloody secretions that may drain down the back of your throat or out your nose during the first few hours; these are normal and should not be confused with thicker active bleeding. Often, when a nasal pack is used, antibiotics may be prescribed to prevent sinus infections.

General ENT

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