Bleeding from Nose

What is bleeding from nose?

Bleeding from the nose  happens easily due to the position of the nose and the proximity to the surface, the position of the blood vessels in the padding of the nose. When the minute blood vessels burst because of hot air, the secure mucus lining inside the nose gets dry which leads to bleeding. Although in some rare cases, the inability of the blood to clot can also induce the nose to bleed at times. While in other situations, high blood pressure can as well be a reason for bleeding from the nose. Based on the location and the intensity of an injury, nosebleeds can be described as minor or major. 

Consult Dr G V K Chaitanya Rao – Best ENT Doctor in Hyderabad.

Medically termed as Epistaxis, bleeding from the nose is interpreted by the site of the bleed. Primarily there are two types of nosebleeds and one is more severe than the other.

  1. Anterior nosebleedIt begins in the front of the nose on the lower region of the wall separating the two passages of the nose (called the septum). As the capillaries and small blood veins in this frontal area of the nose are feeble and can easily rupture and bleed. This is the commonest form of nosebleed and is generally harmless. Anterior nosebleed is more prevalent among children and can be cured at home itself.
  2. Posterior nosebleed – Posterior nosebleed arises deep inside the nose. This is triggered by a bleed in larger blood vessels in the hind part of the nose near the throat. Posterior nosebleed possibly can turn into a more serious nosebleed than anterior nosebleed. It can result in profuse bleeding, which may drip down the back of the throat. Common among the adults, this type of nosebleed requires immediate medical attention. 

Causes Of bleeding from nose

As mentioned above, bleeding from nose are mainly of two types, anterior and posterior. On the basis of this, the causes of the bleeding from nose can be listed as:

Causes of Anterior nosebleed –

  • Picking of nose
  • Blowing of nose harshly
  • Slight injury to nose
  • Stuffy or blocked nose
  • Sinusitis
  • Dry air
  • Allergic rhinitis and non allergic rhinitis
  • High altitude
  • Excessive usage of nasal sprays and decongestants
  • Deviated nasal septum

Causes of Posterior nosebleed –

  • Blow to one’s head or a fall
  • Broken nose
  • Recently done nasal surgery
  • Hardened arteries
  • Medications that causes one to bleed easily
  • Tumor in the nasal chamber
  • Blood clotting abnormality
  • Hereditary hemorrhagic telangiectasia
  • Leukemia

Other Causes –

  • Inserting objects into nose
  • Cocaine and other drugs inhaled through the nose
  • Chemical irritants
  • Alcohol consumption
  • High blood pressure
  • Nasal polyps
  • Immune thrombocytopenia

Severity Of bleeding from nose

Majority of nosebleeds are not serious and can be treated at home. But in the following cases it is advised to visit an ENT specialist –

  • Repeated occurrences of nosebleeds can be an early warning signal of other medical complications that needs to be examined
  • Nosebleeds beginning in the hind of the nose generally involve large blood vessels which results in heavy bleeding and can be severe
  • Bleeding occurs post an injury 
  • Bleeding does not stop after 20 minutes of applying direct pressure

Who can suffer from bleeding from nose ?

People who can suffer from a nosebleed can be summarized as:

  • Children between ages two and 10 – Dry air, colds, allergies, nose picking, sticking fingers and inserting objects into their nose make children susceptible to nosebleeds.
  • Adults between ages 45 and 65 – In middle aged and older adults, blood takes longer to clot. There is also a possibility that they are taking blood thinning medications, suffering from high blood pressure or have bleeding disorders.
  • Pregnant women – During pregnancy, the blood vessels in the nose expands, which ends up putting more stress on the delicate blood vessels in the coating of the nose.
  • People who take blood thinning drugs like aspirin or warfarin.
  • People who have blood clotting disorders like hemophilia or von Willebrand disease.

How to stop bleeding from nose?

Bleeding from nose

To stop a nosebleed or for the management of epistaxis, follow these steps –

  • Use your index finger and thumb to pinch together the soft part of the nose
  • Squeeze the pinched part of your nose towards the face bones
  • Lean forward a bit and tilt your towards the front as well
  • Continue holding your pinched nose for 5 minutes 
  • Repeat the complete process until it stops bleeding from the nose
  • During nosebleeds, keep your head higher than the level of your heart
  • Avoid lying down or putting your head between the legs
  • Try to sit quietly
  • Apply an ice pack on cheeks and nose
  • Consult an ENT physician if the problem persists

Bleeding from nose FAQs

Visit a doctor:

  • If the nosebleed is uncontrollable 
  • If the bleeding is recurrent
  • If the bleeding is profuse
  • If the patient feels week or faints
  • If the nosebleed is an outcome of a facial trauma
  • If the nosebleed is happening with a fever or a headache
  • If an infant or toddler gets a nosebleed

A routine laboratory testing is not required for diagnosing first time or infrequent nosebleeds. Instead an ENT specialist uses:

  • Nasal exam – A nasal examination involves the inspection of the external and internal structures of the nose. 
  • Nasal Endoscopy – It is the procedure to look inside the nasal and sinus passages with the help of an endoscope.

People with symptoms of bleeding disorder and severe or recurrent epistaxis should have complete blood count (CBC), prothrombin time (PT), and partial thromboplastin time (PTT).

To treat bleeding from the nose or the management of epistaxis, the following methods are taken:

  • Nasal packing – Nasal packing is the process of applying cotton or gauze pack to the nasal chambers. Its purpose is to control bleeding and treat chronic nosebleeds.
  • Cauterization – In cauterization, the tissues are burned or dissolved using a hot or cold instrument, an electrical current or a chemical. It seals off blood vessels to stop bleeding.
  • Medication adjustments – Stopping or reducing the usage of blood thinning medications would be beneficial. 
  • Foreign body removal – If the bleeding from the nose is caused due to a foreign body then it will be removed.
  • Correction of a deviated nasal septum – Deviated septum can cause nosebleeds. In such a situation a surgical procedure will be needed to correct it.
  • Ligation – Epistaxis which is not controlled by nasal packing is treated by ligation of blood vessel from which bleeding is originating.

How to prevent bleeding from nose?

To prevent nosebleeds or for the management of epistaxis, take these measures:

  • Practice using saline nasal sprays or drops
  • Use a humidifier
  • Use water-soluble nasal gels or ointments
  • Avoid blowing nose too forcefully
  • Sneeze through an open mouth
  • Curb the use of medications that may increase bleeding
  • Quit smoking
  • Avoid nose picking
  • Keep fingernails short

If prone to nosebleeds then try out:

  • Rubbing ice against one’s nose helps in lessening the swelling in blood vessels.
  • Eating foods rich in Vitamin C like guavas, kale, mustard, parsley, oranges, strawberries, and lemons that help in blood clotting.
  • Wash your face with cold water to keep the nostrils hydrated.
  • Practice taking steam as it cleanses the respiratory passage and keeps the nasal cavity moist. Do not inhale steam for more than a minute once or twice a day.

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Medically reviewed by SinusDoctor,
Dr G V K Chaitanya Rao

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