NOSE BLEEDS (EPISTAXIS)
Condition and Symptoms
Mrs Bentley often sees patients with recurrent nosebleeds (epistaxis). These can be dramatic and frightening, fortunately, most nosebleeds are not serious, although sometimes medical intervention may be necessary.
Most nosebleeds do not have an easily identifiable cause. However, trauma to the nose is a very common cause of nosebleeds. Nosebleeds can be caused by trauma to the outside of the nose from a blow to the face or trauma to the inside of the nose from nose picking. Other conditions that predispose a person to nosebleeds include:
exposure to warm, dry air for prolonged periods of time
nasal and sinus infections
nasal foreign body (object stuck in the nose)
vigorous nose blowing
deviated or perforated nasal septum
Less commonly, an underlying disease process or taking certain medications may cause a nosebleed or make it more difficult to control.
Topical nasal medications, such as corticosteroids and antihistamines, may sometimes lead to nosebleeds.
Vascular malformations in the nose and nasal tumours are rare causes of nosebleeds.
If the person is not at high risk of having a serious underlying cause, treatment options for recurrent epistaxis may include:
Topical treatment with an antiseptic preparation.
Silver Nitrate nasal cautery; this can be performed in the clinic at the initial consultation. This is very well tolerated and is performed under a local anaesthetic spray to numb the area.
This is often used in an operating theatre, and normally requires an anaesthetic.
In severe cases one of the main blood vessels in the nose can be clipped (tied off), so that the bleeding is reduced. This is performed endoscopically ( so no external scars). It takes about 30 mins and most people can go home on the same day.