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What is it about ?
A nosebleed (epistaxis) can occur when the small blood vessels in the front of the septum that separates the two nasal passages (nasal septum) are damaged by infection, dryness, or a propensity to flush the nose.
Other causes of a nosebleed include:
- a foreign body in the nose,
- a lesion in the nose (for example, a broken nose),
- a respiratory tract infection (especially in children),
- a runny nose from an allergy,
- calcification of the arteries (arteriosclerosis) at an advanced age,
- bleeding disease (for example, a lack of platelets),
- taking medicines which influence the tendency to bleeding or coagulation (for example, aspirin or anticoagulants).
Sometimes it happens that no cause is found.
In children and young adults, the bleeding is usually in the front of the nasal septum. In older people, bleeding can also occur from the back or upper part of the nose. Nosebleeds are more common in winter, because the air is drier and colds cause dryness and inflammation of the nasal lining.
How to recognize it?
A nosebleed is easily recognized by the blood flowing from the nostril.
How is the diagnosis made?
A nosebleed is an easy diagnosis for the doctor. He will look inside your nose with a special device and ask you a few questions to determine the cause:
- Are you bleeding from one nostril?
- In case of repeated nosebleeds: are you always bleeding from the same nostril?
- How long does the bleeding last? Does the bleeding stop quickly?
- Did you clean your nose or put something in your nose? (common in children)
- Did you get hit on the nose?
- Do you have a cold?
- Are you using blood thinners?
- Are you using aspirin?
- Have you ever had a nosebleed often?
- What have you tried to stop the bleeding before?
- Do you have any other symptoms (for example, spontaneous bruising (bruising), bleeding gums, blood in the urine)?
The doctor will refer you to an otolaryngologist (ENT) in the following cases:
- a young child who often bleeds from the nose because there is a possibility that a foreign object is in the nose);
- a young person who often has nosebleeds from the back of their nose, as the cause may be a benign tumor;
- an adult who often has a discharge containing blood from one nostril to make sure there is no tumor.
What can you do ?
Sit down with a slight lean forward. This way, you will be able to let the blood flow through your nose instead of letting it flow down your throat. Blow your nose well and remove any blood clots.
Then pinch your nostrils together; place your fingers just below the transition area between the hard and soft part of the nose. You can also use a cool cloth to do this. Apply light, but sufficient, pressure for 15 minutes. Watch the clock to make sure you keep the pressure on long enough.
During this time, breathe calmly through your mouth and do not panic. If necessary, repeat the procedure a second time. You can insert a cotton pad in the front of the nose. Taking an ice cube in the mouth or applying a cold pack to the back of the neck can help stop the bleeding.
If the bleeding does not stop despite these measures, see the general practitioner.
If the bleeding has stopped, avoid touching your nose for 2 to 3 days (do not pick your nose or blow your nose). Avoid anything that increases pressure in your head or nose or dilates blood vessels, such as pushing, lifting, bending over, drinking hot drinks, or taking a hot bath.
Try to increase the humidity in your living room or bedroom and in any case avoid smoke, as it dries up the mucous membranes.
What can your doctor do?
When you have a nosebleed, the doctor will ask you to blow your nose to clear the blood clots and to put pressure on the nose, then he will suck out the remaining clots with a special small device. Equipped with a headlamp and a nasal speculum, he will try to determine the exact location of the bleeding. He will put a cotton ball soaked in a specific solution into your nose to stop the bleeding; it can also use a gelatin-based product. Then the nostrils should be pinched for at least 15 minutes. Normally the bleeding stops. If a little bleeding is still visible, the doctor will cauterize it with a heated silver nitrate bead. If the bleeding has not stopped or has been profuse, he will introduce a nasal tampon that will stay in place for 1 to 3 days.
Sometimes the doctor will prescribe a nourishing nasal ointment that you need to use for several weeks to prevent scabs from forming and repair the nasal lining.
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