Epistaxis is another term for a nosebleed. Most nosebleeds are not serious, but can be an inconvenience. This is because the lining of the nose has lots of tiny blood vessels which are necessary to help humidify the air we breathe. Nosebleeds can affect everyone, but they are far more common in children than adults.
Most commonly, a nosebleed occurs when one or more of the tiny blood vessels rupture as the walls of the vessels are very fragile and can break easily. The majority of nosebleeds are venous. Most nosebleeds originate from the front part of the nasal septum, called Little’s area. Some factors which can cause a nosebleed include:
- Hot weather
- Trauma to the nose
- Sinus infections
- Coughing and sneezing
- Excessive straining (e.g. in constipation)
- Allergies and hayfever
- Medications, such as warfarin, which increase the propensity to bleed
- Nose picking
- Foreign bodies in the nose
- Coagulopathies (clotting disorders)
The majority of nosebleeds can be stopped at home by applying pressure to the soft, cartilage in the lower part of the nose. It is best to sit upright with your head leaning slightly forward. Applying an ice pack over the bridge of the nose can also help to reduce the bleeding. Hold your nose firmly for around 10 minutes until the bleeding stops – try not to release the pressure to see if the bleeding has stopped in the interim. Once the bleeding has stopped, do not blow your nose as this can cause the bleeding to happen again.
For more severe nosebleeds, other treatments may be required. Sometimes the nose may be packed with gauze to help stop the bleeding. This might need to be in for a few days. The packing may dissolve by itself, or you may need to have it removed by your doctor. Often, antibiotics will be given or applied to the packing itself to reduce the chance of acquiring an infection. Ointments or sprays containing vasoconstriction agents may also be used. These are medications which cause the blood vessels to contract and help stop the flow of blood.
If nosebleeds are persistent, cautery may be required. Cautery uses heat or cold to seal the wall of the blood vessels so that they are less likely to rupture and cause persistent nose bleeds. Cautery is not recommended for young children, as they may not keep still long enough to have the treatment. Another option which may help people with persistent nosebleeds and dry nasal passages is using Vaseline or nasal sprays to moisten the mucous membrane lining and help prevent nosebleeds.
If you have any questions about epistaxis make an appointment to see our ear nose and throat specialist.