Nosebleeds are one of the most common complaints in the ENT field. Almost everyone has had a nosebleed at least once in their life. Although it is usually due to simple causes and is easily stopped, sometimes the cause is very serious and life-threatening bleeding may occur.
Why Does the Nose Bleed Frequently?
The inside of the nose is quite intense. and contains superficial veins. Especially the front part of the partition that divides the nasal cavity into two is a section where the vessels coming to the nose meet each other and these vessels are quite superficial. Especially in children, this part may bleed even without any effect. The flesh called turbinates, located on both sides of the nasal cavity, is very rich in vessels and is the cause of some bleeding.
What are the Causes of Nose Bleeding?
Nose bleeding can be caused by both nasal causes ( It develops due to both local causes) and problems outside the nose (general causes).
Local Causes:
-Inflammations inside the nose
-Sinusitis
-Blows to the nose
-Children's nose picking
-Foreign objects inserted into the nose
-Intranasal and sinus tumors
-Bone curvature in the nose (septum deviation)
-Allergic rhinitis
General Causes:
-Hypertension
-Blood Diseases (Bleeding-clotting disorders, leukemia, etc.)
-Intestinal Parasites
What Examinations Should Be Done?
The first thing to do, especially in severe nosebleeds, is to stop the bleeding, regardless of the cause. After the bleeding is stopped, some research should be done on the cause. The first thing to do to investigate the cause is to examine the patient. The cause can be understood with many examinations. Tests that can be performed depending on the suspected cause are as follows
-Measuring blood pressure
-Taking sinusitis films (normal films or tomography)
-Intestinal parasite investigation
-Bleeding-Coagulation tests
- Tests related to blood diseases
These tests are not always applied to every patient. Depending on the reason the doctor suspects, some of them are done to try to find the cause.
How Is It Treated?
Many nosebleeds occur spontaneously or the patient suffers from this. It stops by holding the tip of the rune and applying cold. However, bleeding that does not stop requires medical attention. Interventions that can be done to stop bleeding are as follows:
-Burning of the Vein:
It is used for mild and frequently recurring bleeding. An attempt is made to prevent bleeding by applying chemical substances to the vascular network in the front part of the nasal chamber. There is a risk of perforation of the nasal compartment when applied to both sides or when excessive chemicals are applied.
-Placing a Tampon:
It is a frequently applied treatment method. It is used in bleeding that cannot be stopped by holding the tip of the nose or applying cold. The tampon placed in the nasal cavity stops the bleeding by putting pressure on the bleeding vein.
Gauze applied with antibiotic creams can be used as a tampon, or more comfortable tampons with a tube in the middle that will allow the patient to breathe can also be used. Tampons are usually removed after 48 hours.
Leaving it for a longer period of time can sometimes lead to problematic infections. Giving antibiotics to the patient during the buffer period should not be neglected. Sometimes the source of nose bleeding is the back of the nose and cannot be stopped with tampons placed from the front. In this case, a tampon called a posterior tampon is used, which is inserted through the mouth and placed at the back of the nose.
Connecting the Vessels:
This procedure is a surgery and is severe enough to threaten the life of the patient. It is used for bleeding that does not stop with tampon insertion. The vessel, determined according to the location of the bleeding, is connected sometimes through the sinus and sometimes by opening the neck. Comforting the patient is important during interventions. Especially in elderly and hypertensive patients, diazepam or other sedative medications may need to be given to the patient for this purpose.
What Can I Do at Home When My Nose Bleeds?
Many times, the patient's own methods can stop the bleeding. The first thing the patient should do is to hold the tip of the nose tightly and lean the head forward.
If the head is tilted back, the possibility of blood flowing from the nasal cavity to the throat increases. Applying cold on the nose is also beneficial. The patient can even put a gauze in front of the nose to act as a tampon.
However, the patient Even if the methods used by the patient stop the bleeding, he/she should definitely be examined by an ENT specialist at the appropriate time.
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