epistaxis or nosebleed
What is epistaxis?
Epistaxis or nosebleed is considered the blood spillage produced in the nostrils due to an injury to the blood vessels that line the cartilage of the septum.
Blood vessels in this area of the nose, which separates the nasal chambers, are fragile and tend to break under any irritant or impact situation. Therefore, epistaxis usually appears unexpectedly in some patients.
While in most cases this situation does not require immediate medical attention, there are variations that may require an ENT specialist’s care. Read on and find out all about it.
Causes of epistaxis.
There are many reasons that can trigger a nosebleed, such as a blow to the nose or the introduction of a foreign object, also in response to changes in external factors such as irritation from inhaling certain chemicals.
Diseases such as rhinitis, sinusitis, common cold can cause epistaxis. Some patients with nasal obstruction and deviated septum are also affected by this.
Any situation out of the ordinary can injure the blood vessels of the cartilage and cause an unexpected leakage. For example, patients with prolonged and exaggerated use of nasal sprays can rupture the area and suffer a nosebleed.
Types of epistaxis
A type of hemorrhage in which blood from the nose comes out of the nostrils. It is scanty and stops easily in less than 20 minutes.
Most of these common nosebleeds can be treated at home without the need for medical intervention. This is a condition that stops in less than 20 minutes, is unexpected and is unrelated to any physical injury to the neck or head.
Posterior epistaxis (Requires medical attention):
This is the type of hemorrhage in which the blood goes to the back, i.e., sneaks into the throat or pharynx. It is the least common and requires medical attention.
It is important to identify in which cases we should contact a specialist, whether you are the patient or you are watching someone else go through this condition. The warning signs are:
- The patient suffered a blow to the head or neck and the bleeding is caused by this injury.
- The nose is broken and a deviated septum is noticeable.
- Bleeding does not stop in less than 20 minutes.
- There is a history of severe nosebleeds requiring medical intervention.
- The patient is on anticoagulant drugs that cause them to lose more blood during epistaxis.
- It is a frequent hemorrhage and has several similar events in a short range of time.
- The patient has just come out of a nose or sinus surgery.
To diagnose the cause of the nosebleed, the ENT physician will perform a physical examination to understand the context of the condition. Based on these findings, the physician may rely on a variety of additional tests to find the cause of the bleeding and stop it.
- Nasal endoscopy: This uses a tiny device with a camera that is inserted through the nose and helps the doctor look at the inside of the organ in order to find the problem.
- Computed tomography: It is most common when the presence of foreign bodies or any alarming situation in the sinuses is suspected. It is also ideal to rule out fractures or head injuries.
- Blood tests: These can be a cocktail among which we find toxicological tests to see the possibility of drug abuse, blood levels and coagulation, etc.
Medical treatments for nosebleeds.
Once the real cause of the epistaxis is discovered, it is time to recommend the ideal treatment.
- Nasal plugs: this involves the introduction of special gauze that acts as a plug and helps the blood to coagulate and close the blood vessels on its own.
- Sealing the blood vessels: for this treatment, ENT physicians can use laser with heat or electricity. This is a painless, outpatient option ideal for patients who are unable to clot on their own.
- Solution of the fracture: the physician performs a bone reduction depending on the characteristics of each injury.
- Removal of foreign objects: various tools are used to help the physician remove the object damaging the patient’s nose.
How to prevent nosebleeds?
One of the strongest reasons for epistaxis is the irritation of the nostrils, which is due to dryness in the environment as well as exposure to agents that cause allergies in the patient.
We recommend maintaining a ventilated and cool environment to prevent the nose from becoming irritated in order to reduce or avoid bleeding episodes.
Likewise, you can visit your ENT physician to determine a preventive treatment suitable for your particular condition. One option may be the application of a nasal spray frequently.
Risk factors for epistaxis.
- Cardiovascular problems without specific treatment.
- Sudden touches to the inside of the nose.
- Sports with high risk of injury to the face.
- The use of small objects in children under 3 years old (they can introduce them in the nose or ears).