Frequent nosebleeds: causes, drug and surgical treatment
Frequent nosebleeds are a common reason for visiting an otolaryngologist. In some cases, it even leads to hospitalization of the patient, especially if the bleeding occurs after any injury.
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However, if there was a mechanical impact, there are no problems with making a diagnosis and prescribing treatment, but in other cases it is quite difficult to understand the causes of the pathology. Why does nosebleed occur, how dangerous is it, and what treatment can be prescribed for this condition?
Causes of frequent nosebleeds
Factors that cause frequent nosebleeds
There are many reasons for nosebleeds. The nasal cavity is well supplied with blood, the anterior nasal septum is saturated with blood vessels. Even a minor blow or any injury immediately leads to bleeding. Every person has encountered this unpleasant phenomenon at least once, but most often the bleeding itself stops after a while, and no more problems arise.
However, it is necessary to sound the alarm if nosebleeds begin to occur for no apparent reason, they recur and are difficult to stop.
There are several common external causes:
- Sun and heat stroke. When the body overheats, dizziness, nausea, tinnitus are observed; a common symptom associated with increased blood pressure is nosebleeds. Overheating can be very dangerous; it is necessary to take the victim to a cool place as soon as possible and provide first aid.
- Intoxication, poisoning, exposure to various chemicals. The blood vessels of the mucous membrane are constantly exposed to negative effects among chemical industry workers, those who work with various volatile substances, etc. Chronic poisoning leads to serious disorders in the body, manifested by frequent bleeding.
- Taking antihistamines and some other medications. Long-term use of aspirin can lead to bleeding - it helps reduce clotting and thins the blood.
In addition to external causes, frequent nosebleeds can occur due to various infectious diseases. These include tuberculosis, syphilis, and liver and kidney diseases also negatively affect the condition of the mucous membrane. Blood often comes out of the nose with high blood pressure: in this case, the patient feels tinnitus, dizziness, and weakness.
Also, frequent nosebleeds occur with increased fragility of blood vessels, bleeding disorders and other diseases of the circulatory system.
In any case, if frequent causeless bleeding is observed, it is necessary to undergo a full examination as soon as possible in order to identify and eliminate the cause.
First aid for nosebleeds
Rules for stopping nosebleeds
If a nosebleed begins, it is important to provide the patient with first aid correctly. Often people begin to panic at the sight of blood - this further increases blood pressure and only increases bleeding. But if you know what to do, you can easily avoid unpleasant consequences for the body.
The person must be seated, ensuring peace. The head is not thrown back: blood should not enter the stomach, otherwise it may provoke vomiting. You should not blow your nose when bleeding - this will not help the patient, and the bleeding will be more difficult to stop. The head should be slightly tilted forward, a cotton swab should be placed in the nostril: it helps to form a plug and stop the bleeding.
You need to apply a cold object to the bridge of your nose - this will help narrow the blood vessels, and the blood will stop faster.
If the patient has lost consciousness, he should be placed on his back with his head turned to the side to avoid blood entering the stomach. If first aid for a nosebleed does not produce results, you must call an ambulance.
Useful video on how to properly stop a nosebleed.
When is it necessary to urgently call a doctor? You need to pay attention to the warning signs:
- Severe bleeding that does not stop for a long time. It is necessary to stop the bleeding as quickly as possible, and for this you have to use medical assistance.
- The appearance of weakness, cold sweat, black spots before the eyes. As a rule, this condition is observed with severe blood loss, which needs to be stopped as quickly as possible.
- General deterioration in health. Nosebleeds are just one symptom that may indicate a serious illness.
Treatment
Ways to treat frequent nosebleeds
Treatment for nosebleeds depends on the cause of the pathological condition. First of all, it is necessary to exclude exposure to hazardous factors: mechanical and chemical influences, the negative effects of medications, etc.
It is necessary to avoid overheating the body, too intense physical activity and other factors that can cause bleeding. If their cause cannot be immediately established, the doctor will prescribe a full examination, based on the results of which treatment will be prescribed.
Depending on the identified cause, the doctor may choose one of the following methods of treating nosebleeds:
- If they are caused by polyps (benign tumors) in the nasal cavity, surgical treatment may be prescribed. The doctor will perform an operation and remove all formations from the nasal cavity, after which the bleeding will completely disappear.
- If bleeding occurs due to chronic rhinitis or other inflammatory processes, the doctor will prescribe vasoconstrictor drugs and special aerosols; treatment methods depend on the severity of the disease.
- If nosebleeds occur due to damage to the nasal septum by chemicals, it is necessary to completely eliminate the damaging factor, after which a diet and special products with vitamins A and E are prescribed. They promote faster healing and restoration of blood vessels.
- In case of bleeding due to long-term use of blood thinning drugs, the course of treatment must be reconsidered. Long-term use of such drugs poses a serious threat to human health: blood can come not only from the nose, but also serious internal bleeding with unpredictable consequences.
- If they are caused by any systemic diseases, complex therapy will be prescribed. It is necessary not only to remove the symptom, but to eliminate the very cause of its occurrence - this could be an infection, an allergic reaction, a benign or malignant tumor, etc. In all cases, after eliminating the cause, nosebleeds will disappear.
If an alarming symptom appears at least several times, it is imperative to start treatment. Bleeding from the nose is one of the first symptoms of such terrible diseases as cancer, diabetes, atherosclerosis, heart failure, etc. For frequent bleeding, the doctor will prescribe drugs that help increase blood clotting: these are Vikasol, calcium chloride and gluconate, as well as large doses vitamin C.
Surgery
In approximately 10% of cases, nosebleeds have to be stopped surgically.
The doctor may use one of the following techniques:
- Cauterize the damaged vessel with a cotton swab dipped in a solution of silver nitrate. This procedure allows you to reliably stop bleeding due to crust formation.
- In difficult cases, coagulation of the vessel is prescribed: modern technologies allow it to be carried out painlessly using a laser or electric current. Severe blood loss may even require plasma and donor blood transfusions.
- For local bleeding, solutions of lidocaine or novocaine can be injected directly into the mucosa. During the surgical operation, the doctor performs resection of the cartilage and gentle local intervention in the mucous membrane.
- Cryotherapy is freezing the damaged area using liquid nitrogen. This technique avoids the appearance of scar tissue. In addition, it causes minimal discomfort to the patient.
Modern technologies have expanded the capabilities of specialists: operations are carried out using the most gentle methods, which do not require long recovery and allow obtaining a guaranteed result.
Possible complications
Consequences of improper treatment of pathology
Nosebleeds can be not only anterior, but also posterior: in the second case, blood begins to flow from the posterior wall of the nasal cavity, and in this case it is difficult to assess the extent of blood loss. If blood enters the stomach, it provokes vomiting of dark blood, which will only worsen the patient’s well-being. In this case, it is very difficult to stop the bleeding on your own; it is necessary to call an ambulance and provide assistance to the patient as quickly as possible.
It is important to correctly determine the source of bleeding. If the blood bubbles, this indicates pathologies of the respiratory system; this condition requires immediate medical intervention. Foamed blood indicates pulmonary hemorrhage - it can lead to the most severe consequences for the patient.
Intense bleeding leads to rapid blood loss: hemorrhagic shock occurs - a dangerous condition that can ultimately lead to death.
Delay is extremely dangerous for the patient; if you cannot stop the bleeding on your own, you need to call an ambulance as soon as possible.
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Nosebleed
diseases of the nose and paranasal sinuses (sinusitis, rhinitis),taking a number of medications,Causes of epistaxis in adults
painful sore or swelling in the nose,bloody discharge from the nose (clear in appearance),Causes of epistaxis in children
Persistent, frequent nosebleeds in children, which are combined with a tendency to bruise, may indicate hemophilia or a number of other diseases that are associated with blood clotting disorders.
Causes of epistaxis in pregnant women
inhalation of frosty or dry air for a long time (during walks in winter),lack of calcium or vitamin K in the body, which occurs during pregnancy and can cause epistaxis, as well as increased bleeding of the gums, etc.nosebleeds accompanied by severe pain in the head may occur due to high blood pressure. In this case, medical attention is required. Your blood pressure will be measured and the likely cause of the bleeding will be determined. First aid for nosebleeds in children and adults
1. The patient should be seated and his head tilted forward. It is strictly forbidden to tilt the patient's head back to avoid swallowing blood and vomiting or blood entering the respiratory tract!
2. It is necessary to provide the patient with epistaxis with good access to fresh air (open the window, unbutton the patient’s shirt collar).
3. Place an ice bag on the person's nose. If the bleeding does not stop, use your finger to press the nostril firmly against the nasal septum for about 5-10 minutes. Due to compression of the vessels of the nasal mucosa, bleeding stops in most cases.
4. If the cause of nosebleeds is a trauma to the nose, and it is accompanied by changes and swelling of the contour of the nose or the entire face, place a handkerchief or a bag of ice soaked in cold water on the nose area and consult a doctor immediately.
5. If the measures taken do not help stop the nosebleed, you can use any vasoconstrictor medicine for the runny nose (for example, Naphthyzin, Naphazolin, Sanorin, etc.). To do this, make a tampon from a small piece of gauze or bandage, approximately cm long. This swab must be soaked in the medicine and inserted into the nasal cavity.
6. When nosebleeds are the result of a previous runny nose, it is necessary to lubricate a cotton swab with Vaseline and insert it into the nasal cavity. As a result of the action of Vaseline, the crust formed in the nose will soften and the bleeding will stop.
7. When bleeding from the nose occurs due to overheating, you must immediately take the patient to a well-ventilated place where the sun's rays do not penetrate. Apply a cloth soaked in cold water or ice to the nose area.
In what situations do you need to see a doctor urgently?
with nosebleeds resulting from trauma, combined with deformation and swelling of the nasal contours; for frequent nosebleeds that do not stop for a long time, accompanied by a tendency to bruise and increased bleeding of the gums, etc.Treatment of nosebleeds
1. Nasal tamponade is a method of stopping nosebleeds that involves inserting gauze into the nasal cavity, pre-treated with Vaseline or a special paste that promotes blood clotting. There are two methods of inserting a tampon: anterior tamponade (insertion of a tampon from the nostril side) and posterior tamponade (from the oropharynx).
2. The use of surgical methods to stop nosebleeds is suggested in situations where other methods are ineffective, and involves blocking or ligating the arteries supplying the nose with blood, and a number of other measures.
Comments
but today the nosebleed lasted for a long time, what should I do? What antibiotics can you take without a doctor's prescription?
[keep it up, but be sure to write back after the doctor. My son also occasionally gets nosebleeds, especially when he gets overtired. Maybe you are stressed at work too?
Source: http://fitfan.ru/health/bolezni/2402-krovotechenie-iz-nosa.html
What are the reasons for nosebleeds in adults?
Every person has had to deal with nosebleeds at least once. But not everyone knows why nosebleeds occur. The reasons for this phenomenon in an adult can be very different: overwork and fatigue, nasal injuries, as well as other more serious diseases.
In cases where nosebleeds occur quite often, you should immediately undergo a medical examination to identify the true cause or disease.
Such symptoms can signal a disease of various internal organs - liver, kidneys, and blood. In addition, nosebleeds can be caused by cardiovascular diseases, rheumatism and various infectious diseases.
Classification
The volume of blood leaking from the nose can range from several milliliters to half a liter.
- Blood loss of a few milliliters is considered insignificant. Such bleeding is not dangerous to health and does not lead to any consequences. The only negative point may be fear, hysteria or fainting in young children.
- Blood loss is assessed as moderate if its volume does not exceed 200 ml. Such blood loss causes slight weakness, dizziness, rapid pulse and flickering of spots before the eyes. Visible mucous membranes and skin may become pale.
- We are talking about massive blood loss in cases where up to 300 ml of blood flows out in total or simultaneously. It is accompanied by more severe symptoms compared to mild ones: weakness, tinnitus, dizziness, headache, thirst, shortness of breath.
- Profuse bleeding is characterized by a large volume - 500 ml and above. Massive blood loss leads to hemorrhagic shock, expressed in a sharp drop in blood pressure, lethargy, various disturbances of consciousness up to its loss, and insufficient blood circulation in the internal organs.
Also, nosebleeds can be divided into local and general. Local are those that cause bleeding when the nose is damaged locally, and general are those that cause bleeding in general.
Why does an adult have nosebleeds: reasons
Drops or streams of blood appearing from the nasal passages are a consequence of vascular damage. This happens as a result of either mechanical impact (trauma to the nose) or internal processes in the body.
Let's take a closer look at the main reasons why an adult may have a nosebleed, and what to do in this case:
- Trauma - most often, various blows to the face area lead to injury to the nose, which may be accompanied by a fracture of its septum with the development of severe bleeding. In childhood, injuries to the nasal mucosa are caused by the habit of picking the nose with a finger or other objects (pencil, pen).
- Impact of external conditions. Long exposure to the sun, overwork, physical activity are factors that can cause spontaneous nosebleeds. This is an isolated phenomenon, it is not a reason to go to the doctor, the bleeding quickly stops, and the incident is forgotten.
- Sunstroke and overheating are one of the main factors for nosebleeds, especially in the summer. Due to high temperatures, the nasal cavity becomes dry and the vessels become fragile. They burst easily and cause nosebleeds. To protect yourself from heatstroke, you need to wear a Panama hat or a hat and stay in a shady place as much as possible.
- Drying of the mucous membranes can also cause bleeding from the nose, as the capillaries become fragile. Drying of the nasal mucosa can be the result of prolonged exposure to dry air or frost.
The second group of nosebleeds is usually caused by much more serious reasons, including systemic disorders. In this case, nosebleeds are not a separate pathological condition, but a manifestation of symptoms of diseases of any organs and physiological systems, most often the respiratory and circulatory systems. This group includes diseases such as:
- Hypertension. Increased blood pressure or intracranial pressure can also cause nosebleeds. But this is more of a blessing than a disaster, because it is better to lose a little blood and lower blood pressure than to have a stroke. By the way, most often pressure changes occur from 4 to 6 am. This fact explains why some people have nosebleeds in the morning.
- Inflammatory process of the nasal mucosa (rhinitis) or its sinuses (sinusitis, frontal sinusitis) - inflammation weakens the walls of blood vessels, making them more brittle. Acute respiratory viral infection, allergic rhinitis, bacteria (streptococci, staphylococci, E. coli) can lead to the development of the inflammatory process.
- Papillomas in the nose are growths on the mucous membrane. They are the result of a viral infection and are dangerous due to mutations into malignant formations. Polyps put pressure on blood vessels, make breathing difficult, and cause frequent bleeding in the morning.
- Vegetative-vascular dystonia is accompanied by weak, fragile vessels, often causing nosebleeds in an adult or child diagnosed with VSD. Additional symptoms include watery discharge, headache, and tinnitus.
- Atherosclerosis - changes in blood vessels, loss of their elasticity, frequent damage with the occurrence of various bleedings (internal and external).
- Pheochromocytoma is a tumor of the adrenal gland that causes increased levels of stress hormones. Because of this, the pressure rises sharply and the nose bleeds constantly. Signs of this tumor are frequent nosebleeds and dry nose. If you have such symptoms, you should contact the clinic.
- Taking medications. Bleeding is usually caused by drugs that prevent blood clotting. These include heparin, aspirin and others. Blood from the nose can flow with prolonged and uncontrolled use of nasal sprays that dry out the mucous membrane.
- Oncological diseases. Epistaxis occurs with malignant and benign tumors in the nose. In addition to bleeding, there may be an ulcer on the nasal mucosa, swelling of the nose, and a change in its shape.
- Diseases accompanied by bleeding disorders, such as hemophilia.
- Vitamin C deficiency. As you know, vitamin C strengthens the walls of blood vessels. If there is not enough of it, the vascular walls become loose and brittle. This fact may be the answer to the question why nosebleeds often occur.
In adults, the most common cause of nosebleeds is damage to the vessels of the anterior nasal septum (Kiesselbach's place), which is densely penetrated by a network of small arterioles and capillaries. Such bleeding, as a rule, does not pose a threat to human health. Blood from the nose flows out in drops or a thin stream and, with normal clotting, quickly stops on its own.
The situation is worse when the vessels of the upper and posterior sections of the nasal cavity are damaged. The arteries here are noticeably larger than in the anterior section, and therefore the bleeding is stronger, can cause significant harm to health and even lead to death due to very severe blood loss. In this case, the blood flows in a bright red, non-foamy stream, may appear from the mouth, and practically does not stop on its own.
What to do when your nose is bleeding?
There is no point in treating symptoms exclusively, since the underlying disease must be eliminated. The causes of frequent nosebleeds are determined by your doctor. It is necessary to visit a therapist or pediatrician and otolaryngologist. For diagnosis, you will need to take a general blood test and check blood clotting indicators.
Nosebleeds may not be so harmless. Many people do not pay enough attention to this. If blood from the nose bothers you in rare cases and then due to mechanical action, then there is no need to worry.
If blood from the nose bothers you often, it spurts out, or the bleeding is profuse and prolonged - all this is a signal to seek help from a specialist as soon as possible.
How to stop nosebleeds?
If blood flows from the nose as a result of mechanical damage and there is little blood, and apart from a slight headache, there are no signs of serious illness, you can deal with the problem yourself. The order of tasks is as follows: first we stop the bleeding, then with the help of analgesics you can reduce the intensity of pain.
Take a sitting position and tilt your head back slightly. Loosen your tie and unbutton your collar. Do not tilt your head forward - this will cause a rush of blood to the nose area and increased bleeding. It is also impossible to throw your head back - blood will enter the nasopharynx and lead to vomiting.
You can put a piece of ice or a towel soaked in cold water on the bridge of your nose for a short time, about ten minutes. A napkin moistened with cold water can also be applied to the back of the neck. It is advisable to press the nostril from which the blood is coming from for 5-10 minutes until the bleeding stops. If the bleeding is intense or does not stop, use tampons. For this, cotton swabs soaked in hydrogen peroxide are suitable; they need to be inserted into the nose, but not too deep, and sit for 10-15 minutes.
If there is no tampon and hydrogen peroxide, then insert a bandage into the nostril from which the blood is coming, leaving at least 10 centimeters outside so that it can be freely removed from the nostril. This is done to prevent blood from coming out of the nose. Also, if you have vasoconstrictor medications for nasal instillation, then apply a few drops to a tampon and insert it into your nose. These drops will help close the damaged vessel, which caused the bleeding. Then place the person in a cool, quiet, dark room. It happens that these measures are already sufficient.
If the bleeding is profuse and cannot be stopped quickly enough at home, the headache is severe, speech, vision or consciousness in general are impaired - immediately call an ambulance.
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You just need to use less vasoconstrictors, but on the contrary, it’s better if your nose is a little stuffy.
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Nosebleeds (nosebleeds)
Introduction
Causes of nosebleeds
In children
- foreign body (pea, pencil, button, toy parts);
- when picking your nose.
- nasal injuries (bruise or fracture);
- atrophic rhinitis;
- tumors in the nasal passages (angiofibromas, hemangiomas, polyps);
- drying out of the nasal mucosa, leading to fragility of blood vessels (when in a hot, unventilated room).
- infectious diseases (scarlet fever, influenza, ARVI and others);
- increased body temperature;
- blood diseases with a violation of the coagulation system;
- hereditary diseases (hemophilia);
- increased blood or intracranial pressure;
- liver diseases;
- hormonal changes;
- lack of vitamins in the body;
- physical activity (for example, sports);
- overheating in the sun, sudden changes in atmospheric pressure.
In teenagers
In adults
- nasal injury;
- acute and chronic (atrophic) rhinitis;
- deviated nasal septum;
- benign (polyps, hemangiomas, angiofibromas) and malignant tumors in the nasal cavity;
- burns (thermal, chemical, radiation);
- surgical intervention or medical procedures (puncture of the paranasal sinuses, nasogastric intubation, endoscopy and others);
- foreign bodies (piercing, for example);
- bad habit (nose picking).
The general reasons are also quite varied:
- pathology of the cardiovascular system (heart defects, vascular abnormalities with increased pressure in the vessels of the neck and head, hypertension, vascular atherosclerosis);
- bleeding disorders, blood diseases (leukemia), hemorrhagic diathesis;
- lack of vitamins C and K, lack of calcium in the body;
- increase in body temperature (in case of infectious diseases, overheating, etc.);
- pathological conditions as a result of sudden changes in pressure (in divers, pilots, climbers);
- hormonal imbalances (menopause, pregnancy);
- kidney and liver diseases in the stage of decompensation;
- congenital pathology (hemophilia, Rendu-Osler disease);
- taking medications that prevent blood clotting (Heparin, Warfarin, Pentosan, Aspirin).
Nosebleeds in healthy people can be triggered by significant physical activity or a stressful situation. The cause may also be inhalation of frosty or dry air for a long time, which causes dry mucous membranes and fragility of blood vessels.
In older people
In pregnant women
- Lack of vitamins in the body of a pregnant woman, since the growing fetus also needs vitamins. Due to vitamin deficiency, increased capillary fragility develops.
- Increased blood pressure; This not only contributes to nosebleeds, but can also lead to insufficient oxygen supply to the fetus (fetal hypoxia) and nutrients. The consequence of this is intrauterine growth retardation.
- Increased stress on the cardiovascular system associated with increased blood flow in the mother's body to provide the fetus with nutrients.
- Changes in the blood coagulation system.
Minor nosebleeds that stop quickly and occur no more than once a week are not dangerous, but should be reported to your doctor. This is necessary to exclude conditions that could harm the health of the pregnant woman or fetus.
Symptoms of nosebleeds
Causes and symptoms of nosebleeds - video
Severe, frequent, profuse nosebleeds
- Most often, severe bleeding occurs in severe injuries with damage to the branches of the carotid artery. Such bleeding is often not only heavy, but also recurrent. Moreover, the bleeding may recur (recur) after a few days (or even weeks). Recurrent bleeding can lead to mental disorders: loss of orientation in place and time, anxiety, panic. This is due to hypoxia (insufficient oxygen supply) to the brain.
- A common cause of severe nosebleeds is excessively high blood pressure.
- Heavy and frequent nosebleeds combined with bruising and bleeding gums may indicate bleeding disorders. Such manifestations can occur with leukemia, hemorrhagic diathesis, hemophilia (hereditary pathology in males), and cirrhosis of the liver.
- Frequent nosebleeds may be the first sign of a malignant or benign neoplasm.
Patients need careful examination and treatment. If you have heavy, frequent nosebleeds, you should not hesitate to see a doctor.
Nosebleeds at night
1. Damage to the vascular wall as a result of injury or disease. The vessels of the nasal mucosa can be injured by roughly blowing your nose or picking your nose. And injured vessels may begin to bleed at night.
2. Changes in blood composition or increased permeability of the vascular wall.
3. Increased intracranial or blood pressure.
4. Venous congestion in the sinuses of the brain can also lead to nosebleeds at night.
5. Sleep in a hot, unventilated room.
6. Change in atmospheric pressure.
7. Disturbances in the blood coagulation system.
Nosebleeds in the morning
- coagulopathies (blood clotting disorders) – due to blood disease, vitamin deficiency;
- diseases of the cardiovascular system (heart disease, hypertension, vascular abnormalities, atherosclerosis, etc.); increased blood pressure;
- hormonal changes in the body (during puberty, pregnancy, etc.);
- elevated temperature (in case of infectious diseases);
- overheating in the sun on the eve of bleeding;
- increased intracranial pressure as a result of a sharp morning rise;
- lack of calcium in the body;
- injury received the day before or in the morning (picking your nose, for example);
- overwork, lack of sleep, stress;
- dryness of the nasal mucosa (with atrophy of the nasal mucosa or sleeping in a hot, unventilated room).
In any case, the patient or parents should not be involved in the diagnosis. A consultation with a doctor and examination will help determine the cause and provide treatment.
Recurrent nosebleeds
- you should not blow your nose or even touch your nose after the bleeding has stopped;
- after the bleeding has stopped, use saline solutions purchased at the pharmacy to moisten the nasal mucosa; For this purpose, you can use Vaseline gel;
- control indoor air humidity and use humidifiers if necessary;
- If you need constant or frequent use of aspirin or non-steroidal anti-inflammatory drugs, discuss with your doctor the possibility of switching to Acetaminophen.
What to do if you have a nosebleed (emergency care)
- Sit down and tilt your head forward a little. You should not tilt your head back, as this can cause blood to be swallowed and cause vomiting or enter the respiratory tract. In addition, when the head is thrown back, the venous outflow of blood from the head and neck becomes difficult. This increases blood pressure in the vessels of the head and increases bleeding.
- If the cause of bleeding was overheating in the sun, you should immediately take the person into the shade or into a well-ventilated area.
- Unfasten the collar and open the window for fresh air.
- Apply a bag, bag or ice pack to the nose area. If it is not possible to apply ice, then you need to apply a bandage, cloth or handkerchief moistened with cold water. The same should be done in case of injury to the nose by changing its configuration. In this case, urgent consultation and help from a doctor is needed.
- If the bleeding continues, then you need to press the wing of the nose (nostril) from the outside to the nasal septum with your finger for 5-10 minutes.
- If the bleeding continues, you can moisten a bandage tampon with a runny nose remedy (Naphthyzin, Naphazolin, Sanorin, etc.) or a 3% solution of hydrogen peroxide and insert it into the nasal cavity.
- If the cause of bleeding was overheating in the sun, you should immediately take the person into the shade or into a well-ventilated area.
First aid for nosebleeds - video
Helping a child with nosebleeds
Treatment of nosebleeds
- rapid stop of bleeding to prevent an increase in blood loss;
- hemostatic drug therapy;
- impact on the cause of bleeding.
Drug therapy
Cauterization of the nasal mucosa
Oxygen therapy
Nasal tamponade
Surgical methods to stop nosebleeds
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Causes of nosebleeds
General information
Currently, about 15% of patients visiting otolaryngologists are those who complain of frequent nosebleeds that occur spontaneously.
When blood comes from the nose after injury or other mechanical influence, this symptom is quite understandable to a person. But if this phenomenon repeats constantly, and there are no apparent reasons, then bleeding can seriously worry the patient. Bleeding without a reason can be both abundant and scanty, it can be short-term or long-lasting. Both adults and children suffer from this phenomenon.
However, some people never experience such problems; they are even sometimes interested in how to get a nosebleed without pain.
What can cause bleeding from the nose? First of all, we can talk about violations of the integrity of the walls of blood vessels, as well as poor blood clotting. In most cases (approximately 80%), the blood comes from the vessels of the anterior parts of the nose. If the blood appears from the posterior sections, then it is more difficult to stop, and this condition is more dangerous for health. Indeed, in this case, large vessels are damaged, and blood flows through the nose more intensely.
As a rule, bleeding appears due to a violation of the mucous membrane where the Kisselbach zone, which is located in the anterior part of the nasal septum. Since the mucous membrane in this place is very thin, and there are many vessels in it, even the smallest and most insignificant damage leads to blood running from the nose.
There are many reasons why this manifestation occurs. As a rule, it is associated with blood diseases, some infectious diseases, as well as diseases of the blood vessels, heart, kidneys and liver, and rheumatism.
Sometimes blood is released in streams or drops, sometimes it flows down the back wall of the throat. In this case, a person may notice weakness, dizziness, low blood pressure, tachycardia, and tinnitus.
Why such manifestations are observed every day, you must immediately ask your doctor.
It happens that nosebleeds are confused with the same manifestations from the lungs, trachea, bronchi, stomach, and nasopharynx. It should be noted that pure blood is usually released from the nose. Below we will talk about the reasons for this manifestation and how to eliminate this symptom.
Causes of nosebleeds: the influence of external factors
If a person has a very frequent nosebleed, the causes of this phenomenon are often related to external factors. External causes of nosebleeds can be:
- The air is too dry, which often results in nosebleeds in children. This happens especially often during the heating season - in the mornings and not only the mucous membrane dries out, sticking to the smallest vessels. As a result, they lose their elasticity and burst, which leads to this phenomenon. This can also occur in a teenager during a period of active growth.
- Many people note that they bled due to severe overheating - sunstroke or heatstroke. In this condition, weakness, headache, dizziness, fainting, and tinnitus are also noted.
- Sometimes the answer to the question of what causes nosebleeds is strong changes in pressure, atmospheric or barometric. This happens if a person descends to the depths or rises high into the mountains, or takes off on an airplane to a great height.
- There are other explanations for why nosebleeds occur. The reasons for this may be related to intoxication of the body or poisoning. This can occur due to inhalation of toxic vapors, gases, or aerosols. This also happens due to thermal burns of the mucous membrane, as well as chemical and electrical burns. This can happen with chronic benzene poisoning or exposure to radiation.
- If a person sneezes or coughs very hard, the pressure in the vessels of the nose increases sharply and they become damaged.
- Sometimes the causes of this phenomenon may be associated with the use of a number of medications. In particular, corticosteroids, antihistamines, nasal vasoconstrictors, blood thinners.
Local reasons
Local causes may also explain why a teenager, child or adult often bleeds from the nose.
Consequence of injuries
This is a very common reason, because very often an adult bleeds constantly after accidents, bruises, injuries at home, falls, which lead to fractures of cartilage tissue. As a rule, in addition to bleeding, in this case there is pain and swelling of the surrounding tissues. If there is bleeding due to a fracture of the facial bones or cartilage tissue, then the deformation will be visually noticeable.
Also, injuries to the nasal mucosa occur if specific operations or manipulations for diagnosis are performed: probing, puncture or catheterization of the nasal sinuses.
ENT diseases
If local pathological conditions develop, congestion of the nasal mucosa may occur. This can be observed with sinusitis, adenoids, and sinusitis. Also, such manifestations are possible in people with chronic rhinitis (allergic, etc.), especially if they are accustomed to very often and uncontrollably using nasal drops, which constrict blood vessels. Also dangerous in this case are hormonal medications that provoke thinning of the nasal mucosa and, as a result, its atrophy.
Changes in the mucous membrane, deviated nasal septum, anomalies in the development of veins
In patients with atrophic rhinitis, dystrophic changes in the mucous membrane are noted, which leads to the manifestation of nosebleeds. Anomalies in the development of arteries and veins (their local enlargements), severe curvature of the nasal septum, or the location of mucosal vessels too close to the surface can also lead to bleeding.
Adenoids, polyps, tumors
Sometimes frequent bleeding in women and men is a sign that a benign or malignant formation is developing in the nasal passages. These can be polyps, adenoids, tumors, angioma, specific granuloma.
Foreign bodies in the nose, infection with worms
Often the causes of nosebleeds in a child are associated with injuries from various objects - fingers, toys, etc. Sometimes blood comes if small foreign objects or small insects disappear into the nose. It sometimes flows even after the child has been bathed in an open body of water, since parasites - mites, etc. - can get into the nasal cavity.
Sometimes the explanation for why a child’s nose bleeds at night or in the morning is helminthic infestation, since roundworm larvae, when migrating, enter the lungs, nasopharynx, and other organs and damage blood vessels. Therefore, if your child often bleeds from the nose, you need to check him for the presence of parasites in his body.
In any case, if a child starts bleeding, it is necessary to act correctly, as advised by Dr. Komarovsky and other experts. How to provide emergency care for nosebleeds in children and how to stop the bleeding can be found below.
Common reasons
Sometimes a certain disease causes nosebleeds. Causes in adults and children may be associated with various diseases and conditions. Thus, the causes of nosebleeds in adults, as well as in children, may be associated with increased fragility of blood vessels, which is noted in such cases:
Changes in the vascular wall
Vasculitis, that is, the inflammatory process of the inner lining of blood vessels, leads to the manifestation of light bleeding, in which sometimes hemorrhage occurs in the muscles or joints, and a rash always appears.
Infectious diseases - measles, tuberculosis, influenza, chickenpox, etc., in such conditions pathological changes in the walls of blood vessels occur. If a patient contracts tuberculosis of the nasal cavity, blood crusts may periodically appear in his nose.
Vascular atherosclerosis – this disease can also cause bloody discharge from the nose. It should be remembered that this disease is dangerous, as it can lead to the development of heart attack and stroke.
Hypovitaminosis - sometimes the reason why blood flows from the nose in an adult is a lack of vitamins C, K, and calcium in the body. In this case, the doctor will tell you how to stop bleeding by prescribing vitamin complexes.
Fluctuations in hormonal levels
This also happens if sharp fluctuations in hormonal levels occur in the human body. This is why bloody discharge appears and headaches occur in adolescents, as well as in women during pregnancy and menopause.
Increase in blood pressure
Nosebleeds with blood pressure that has risen sharply are also possible. An increase in blood pressure levels is observed due to emotional and physical overload, as well as due to the development of vascular and heart diseases, etc. At what pressure this can happen depends on the characteristics of the body. But bleeding is most likely to occur during sudden changes in blood pressure: then the walls of the capillaries in the nose rupture, which provokes bleeding. This is possible with the following conditions and ailments:
- atherosclerosis;
- hypertension;
- mitral stenosis, aortic stenosis;
- adrenal tumors;
- heart defects, in which there is an increase in blood pressure;
- emphysema, pneumosclerosis;
- pyelonephritis glomerulonephritis in chronic form;
- excessive stress, physical and emotional.
Blood diseases
- Bleeding disorders are one of the symptoms of a group of diseases, both acquired and hereditary, in which nosebleeds and other bleeding occur.
- Cirrhosis of the liver.
- Leukosili aplastic anemia.
- Decreased platelet production in the body (thrombocytopenic purpura).
Other reasons
In addition to the above reasons, the following factors can provoke such manifestations:
Symptoms of anterior and posterior bleeding
Signs of nosebleeds sometimes complement the signs of the underlying disease, as well as symptoms of acute blood loss. You need to pay attention to the following manifestations:
If minor bleeding occurs, then signs of blood loss are usually not pronounced. Bleeding may occur both inward and outward. If it does not go out and flows along the back wall of the oropharynx, then it can be detected by performing pharyngoscopy. If significant blood loss occurs, a person may experience hemorrhagic shock, in which there is a sharp decrease in pressure, thread-like pulse, and tachycardia.
If anterior bleeding occurs, in most cases (approximately 90%) its source is the Kisselbach area. In this zone there is a large network of small vessels covered with thin mucosa with virtually no submucosal layer.
In such a situation, blood loss is usually minor. It stops on its own - basic first aid for nosebleeds works almost immediately. This phenomenon is not life-threatening.
If posterior bleeding develops, large vessels located deep in the nasal cavity are damaged. This is a dangerous condition for the patient, because bleeding very rarely stops on its own.
The doctor can determine the type of bleeding by examining the patient, performing pharyngoscopy and anterior rhinoscopy.
In addition, during the examination, the doctor can determine the development of pulmonary or gastric bleeding, since in such conditions blood sometimes flows into the nasal cavity. It is not difficult to recognize pulmonary hemorrhage - in such a situation, the color of the blood is bright scarlet, it foams. If it is gastric, it is dark, reminiscent of coffee grounds.
In the case of very intense bleeding flowing down the back wall, vomiting may develop, in which dark impurities are noted.
A general examination to diagnose the underlying disease will help to find out why bloody discharge from the nose appears.
To assess blood loss, the doctor prescribes a coagulogram, as well as a general blood test.
How to provide first aid?
You need to clearly understand what to do in case of nosebleeds in order to help both yourself and your child if severe bleeding develops. It is especially important for parents to know how to stop nosebleeds. After all, this happens often with children.
- If bloody discharge is noticed in a child or an adult, you must immediately give him a semi-recumbent position - sit the patient up, tilt his head forward. You can also apply cold to the bridge of your nose for a few minutes - for example, ice wrapped in a towel or a heating pad with cold water.
- You can also drip vasoconstrictor drops into your nose (these can be drugs Naphthyzin, Nazivin, Galazolin) or 3% hydrogen peroxide, then pinch your nostrils with your fingers.
- If it flows from the nose and does not stop, the same drops or hydrogen peroxide should be applied to a cotton swab and inserted into the nostril, pressing it against the septum.
- Provided that it is flowing from the right nostril, the person needs to raise his right hand up and press his left nostril. If there is bleeding from both, the person should raise both hands up, and the one who helps him can press both nostrils.
- If none of the advice on how to stop nosebleeds quickly is effective, you should definitely call emergency help. It is the doctor who must determine how to stop the bleeding from the nose if it flows non-stop, despite all the measures taken.
After the discharge from the nasal cavity has stopped, there is no need to pull out the tampon too quickly, as there is a risk of damaging the blood clot, after which the attack may recur. It is better to carefully moisten the tampon with hydrogen peroxide, wait until it softens, and only then pull it out.
Even if such an incident occurs just once, it is imperative to take the child to an otolaryngologist to determine the cause of this phenomenon. The doctor will tell you what diseases there are that provoke such a symptom and prescribe tests to determine the diagnosis and prevent relapse.
To prevent dry nose and blood crusts in your baby, 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 drip products based on sea water (Salin, Aqua Maris) into your nose.
In serious cases, when it is not possible to cope with the situation on your own, specialists anemize the mucous membrane with a solution of adrenaline or ephedrine. If anterior tamponade is ineffective, posterior tamponade is performed. However, in most cases, both in children and the elderly, anterior tamponade also 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 are effective methods. Also, in such a situation, sclerosing drugs are sometimes administered, and drugs that increase blood clotting are prescribed.
What can't you do?
- If blood appears from the nasal cavity, you should not lie down or tilt your head back - this will only worsen the situation, and blood in such positions can flow into the respiratory tract or into the esophagus. Getting it into the respiratory tract leads to suffocation, getting it into the stomach leads to nausea and vomiting.
- You should also not blow your nose, as this may dislodge the clot that has formed.
- If a foreign body gets into your nose, you should not remove it yourself - this should be done by a specialist.
When is urgent medical attention needed?
Sometimes, if a person has weak blood vessels or suffers from other diseases, you should not wait until the bleeding stops - you need to immediately call emergency help so that the patient can be helped by a doctor. This is necessary if the following occurs:
- blood pressure increases;
- there was a nose injury;
- the patient has diabetes mellitus;
- the person fainted;
- very heavy bleeding was observed, in which there is a threat of large blood loss;
- if a person has been taking or is currently taking Heparin, NSAIDs, Aspirin for a long time, or the patient has problems with blood clotting;
- if there is vomiting of blood, which may indicate damage to the stomach, esophagus, or lungs;
- If a clear fluid flows along with blood in a person after a head injury, this may indicate a fracture of the base of the skull.
Health care
If an adult or child experiences severe bleeding from the nasal cavity, he is hospitalized in an inpatient department. Even if you managed to cope with the problem on your own, you need to consult with an otolaryngologist later.
If the cause of the problem cannot be found, and such manifestations constantly appear, you need to undergo examination by a number of specialists - an endocrinologist, hematologist, neurologist.
If blood appears from the Kisselbach area, then this area is cauterized to prevent relapses. If necessary, the otolaryngologist practices the following measures:
- removes polyps or foreign bodies from the nasal cavity;
- performs anterior or posterior tamponade, which is impregnated with a 1% solution of feracryl, preserved amnion, epsilon-aminocaproic acid;
- to cauterize the vessel, insert a tampon with trichloroacetic acid and vagotil;
- practices coagulation using electric current, silver nitrate, laser, ultrasound, liquid nitrogen, or performs cryodestruction;
- uses a hemostatic sponge;
- administers sclerosing medications, an oil solution of vitamin A;
- if the blood loss is very serious, the doctor uses fresh frozen plasma, blood transfusion, and administers hemodez, rheopolyglucin and aminocaproic acid intravenously.
If all these methods are ineffective, then a surgical operation is performed - embolization of large vessels in the area of the nasal cavity where problems are noted.
Also prescribed are drugs that increase blood clotting - calcium chloride, vitamin C, Vikasol, calcium gluconate.
If a nosebleed occurs, you should not eat hot food or drink hot drinks afterward, and you should not engage in severe physical activity to prevent the problem from reoccurring.
Prevention
- Sometimes, for the purpose of prevention, Ascorutin is prescribed to children and adults, and treatment of vascular fragility is carried out.
- During the heating season, it is necessary to properly humidify the air in the room.
- It is important to eat a nutritious and varied diet to get all the vitamins and minerals your body needs.
- Avoid injury.
Education: Graduated from Rivne State Basic Medical College with a degree in Pharmacy. Graduated from Vinnitsa State Medical University named after. M.I. Pirogov and internship at his base.
Work experience: From 2003 to 2013 – worked as a pharmacist and manager of a pharmacy kiosk. She was awarded diplomas and decorations for many years of conscientious work. Articles on medical topics were published in local publications (newspapers) and on various Internet portals.
The most obvious symptom is blood coming out of a child’s nose. If this process occurs internally, then the liquid flows into the oropharynx, which is where it is found when pharyngoscopy is performed.
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