Nosebleeds, which most people experience throughout their lives, can be a harbinger of different health problems from time to time. Nosebleeds can originate from any part of the vascular system located anatomically throughout the nasal cavity.
What is Nose Bleeding? Why It Happens?
Nosebleeds are a common health problem in society. Nose bleeds usually occur due to structural diseases of the nose. However, it can also be caused by diseases related to the cardiovascular system such as high blood pressure. In certain cases, emergency intervention of the otolaryngology department may be required, especially since it may be associated with diseases of the anatomical structures in the nose. Although it can be seen in one out of every 10 people in the community, only 1-2% of people with nosebleeds require surgical treatment.
The layer that covers the inner surface of the nasal cavity, called the mucosa, is rich in vessels. In addition, since the arteries through which clean blood circulates in the body are close to the surface in the nasal mucosa and often establish connections with other vessels, nosebleeds can cause serious blood loss. Surgical intervention is inevitable in this type of bleeding. Trauma or other factors that may occur in the veins frequently can also cause bleeding.
Nose bleeds are divided into two according to the anatomical region and associated vascular system; anterior nosebleeds and posterior nosebleeds. The most common type of nosebleeds are anterior nosebleeds. Anterior nose bleeding, which is often caused by trauma in the nose, is especially seen in children and young people.
Back nose bleeding is more common in adults and older people. In this type of bleeding, blood comes from the mouth as the nasal cavity is connected to the mouth through the nasal cavity. Often there is an underlying structural problem or chronic disease.
What are the Causes of Nose Bleeding?
The most common causes of nosebleeds:
- Traumatic factors such as nosebleeds and blows to the nose,
- Strong blowing or sniffing,
- Cold and dry air,
- Continuous use of nasal spray,
- High altitude,
- Sinusitis, common cold Diseases such as cold, flu,
- The bone or cartilage in the nose is deformed marrow (deviation),
- Various infections involving the nasal mucosa,
- Allergic rhinitis,
- High blood pressure (hypertension),
- Some hormonal diseases,
- Bleeding disorders (such as the use of blood thinners such as aspirin or hemophilia),
- Liver and kidney failure,
- Sinus tumors.
In nosebleeds due to hypertension, headache and a throbbing sensation in the neck are often seen before the bleeding. If the body cannot tolerate the high pressure in the vessel wall, the capillaries in the nose crack to reduce the pressure in the brain vessels. This is a temporary solution that the body produces. Systemic blood pressure should be reduced as soon as possible with appropriate treatments.
What are Anterior Nosebleeds?
It is mostly seen in children and young adults. Most nosebleeds occur as a result of damage to a capillary network in the middle of the nose. For this reason, it is often observed unilaterally. Since the vessels in this area are very thin and superficial, traumas such as blowing the nose, playing with the nose in children, inserting a foreign body into the nose are often identified as the cause.
Small age, 2 or 3 year old, nosebleeds are most commonly caused by irritation of the mucosa (foreign body insertion) and upper respiratory tract infections (especially viral). The causes of nosebleeds in adults are also valid for young children.
Nosebleeds in babies should be evaluated by a physician as it may be a precursor of systemic diseases such as hemophilia and blood diseases.
What are Posterior Nosebleeds?
It is frequently observed in middle and advanced ages. An underlying chronic disease (especially hypertension, various bleeding disorders, infections, etc.) or a structural problem (sinus tumor, lymphoma, previous surgical procedure, etc.) is usually determined as the cause of bleeding. Bleeding occurs in our nose from the posterior upper regions and its severity is phased compared to anterior nose bleeding. la. Often, blood comes from the nasal and nasal passages at the same time. Since posterior nosebleeds are more difficult to detect and control, the need for emergency intervention is more frequent.
How to Differentiate the Cause of Nosebleeds?
What is the intervention to the bleeding, first of all, depends on where the bleeding originates from and its severity. determined accordingly. If the nose is bleeding from the front and the source of the bleeding can be seen, the bleeding can be intervened by direct pressure. However, in severe posterior nosebleeds, blood may also come from the nostrils.
Anterior nosebleeds are often caused by crusting in dry climates or in winter months, as a result of the drying of the protective layer covering the inside of the nose due to dry and hot room air. To prevent this, a small amount of emollient cream or drops can be applied inside the nose. Generally, it can be stopped by finger pressure applied to the anterior part of the nose (nostrils, the soft area between the nostrils and the nasal bone). Bleeding continues to the mouth and throat. Bleeding from this area will be more severe and should be taken seriously. Therefore, the hospital should be consulted and the patient should be evaluated with an ENT specialist. If the blood is bright red in color, a health institution with an ENT specialist should be consulted since surgical intervention may be required.
How to Intervent Nosebleeds?
There are some methods that can be applied in the treatment of nosebleeds:
- It is necessary to try to calm the person who is bleeding.
- Those who are excited and panicky, their blood pressure rises and the severity of bleeding may increase.
- The head should be tilted slightly forward (not back), and the blood should be swallowed and not go to the stomach. Otherwise, the amount of bleeding may not be understood and may lead to nausea and vomiting.
- The soft part of the nose should be grasped completely and pinched with thumb and index fingers for 5 minutes.
- You should sit upright or lie down with your head elevated if you need to lie down.
- Don't stay standing, sit somewhere.
When is Nosebleeds Dangerous?
- Recurrent nosebleeds,
- From other places than the nose in case of bleeding (for example, with urine and defecation),
- If bruising and bruises occur even with light impacts on the body,
- In the presence of abnormally severe gum, nose or menstrual bleeding,
- In cases where blood thinners are used
- In cases where there are diseases such as liver, kidney or hemophilia that may cause coagulation disorders,
- If chemotherapy has been taken recently,
- 10 minutes If the bleeding still continues even though the nose is compressed throughout,
- Bleeding recurs after a short time,
- If there is a feeling of fainting, lightheadedness or fainting
- If there is palpitation or difficulty in breathing
- If there is blood coming from the mouth with spitting up blood or vomiting,
- If there are additional symptoms such as 38.5 degrees fever and rash/redness, it is necessary to apply to a health institution with an otolaryngologist without losing time.
How to Treat Nosebleeds?
In anterior nosebleeds where the bleeding does not stop, bleeding can be stopped by making a limited buffer or by coagulating the vessel with a minor intervention.
If the bleeding has stopped or does not bleed again after the tampon is removed; In order to prevent bleeding from recurring, emollient and wound healing creams or ointments are often recommended.
Otorhinolaryngologist; can perform an endoscopic examination to see the location of the nosebleed. For bleeding from the front or the back; tip Cauterization can be done with small sticks containing chemical substances or bipolar. In this type of bleeding, patients may need to stay in the hospital for 24-72 hours and be followed up.
After the cause of bleeding is found, additional treatments are also applied. Angiography-guided embolization can also be applied in very serious nosebleeds that cannot be stopped with tampons and surgical methods.
Read: 0
