Nose

Frequent nosebleeds - causes, therapy and symptoms

Frequent nosebleeds - causes, therapy and symptoms


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The nose bleeds when a blood vessel bursts in the nose. Frequent nosebleeds rarely endanger life and usually stop on their own - but sometimes dangerous illnesses are the cause.

Blood in the nose can look horrible, but can usually be treated with home remedies. Anyone can be affected, but it is most common among young children, the elderly, pregnant women, people taking aspirin or blood thinners, or people with blood disorders.

The anatomy of the nose

The nose consists of cavities in a framework made of bones and cartilage plates. Inside are the two nasal cavities, separated by a septum and connected to the frontal sinus, maxillary sinus and sphenoid sinus.

The nasal conch, three bone bars protrude into one of the two nasal cavities. The upper pharynx begins at the back of the nose.

The sensitive olfactory mucosa covers the upper turbinate up to the nasal septum. Here we absorb the smell, the mucous membranes send the information on to the olfactory bulb. These are in turn connected to the olfactory brain via the olfactory cord.

What role do the mucous membranes play?

Inside is the mucous membrane of the respiratory tract, covered with hairs that bring mucus and foreign substances into the throat.

These mucous membranes are well supplied with blood. Your glands secrete fluid to moisturize the air you breathe. Blood vessels supply the mucous membrane and it swells quickly. If these vessels are injured or irritated, bleeding will result.

How common is nosebleed?

Bleeding from the nose is the second most common spontaneous bleeding. Every third child under the age of 5 bleeds the nose at least once, every second child up to 10 years has had nosebleeds. Rarely, however, the nose bleeds in small children and irregularly after puberty.

The nose bleeds more often in the late autumn and winter months when the apartment heaters keep the air dry. Nosebleed is also more common in children who live in a dry climate.

Two types of nosebleeds

The blood comes from either the front or the back of the nose. Bleeding in the front part is the least dangerous and most common, especially in children: colds, allergies, abrupt changes in temperature and dry heat damage the mucous membranes. Repeated sneezing and blowing your nose will burst small blood vessels.

This light bleeding can easily be stopped by holding the nostrils or pressing a handkerchief on the nose.

Blood in the upper area can be more serious and is also more difficult to locate and control. Older people are mostly affected and diseases such as arteriosclerosis can be the cause.

Causes

The most common cause of a bleeding nose is violent injury. People with allergies, hay fever and sinus infections swell the nasal membranes, they become more sensitive and therefore bleed more easily.

Damage to the nose from falls, exercise or fights also causes bleeding. Be careful if your nose bleeds after you injure your head: it may be a skull fracture.

Chemical substances such as cleaning agents, sprays and paints can irritate the nose and lead to nosebleeds. This also applies to some drugs like cocaine: if they are sniffed, the nose becomes inflamed and bleeds.

Changes from cold to warm air or from dry to moist put a strain on the nasal mucous membranes and make them vulnerable. Older people are more often affected by nosebleeds in winter because their mucous membranes are no longer elastic and dry air causes the blood vessels in the nose to burst.

Colds and other diseases that burden the mucous membranes are also more common in winter. They stress the nasal passages and therefore also promote injuries.

Which diseases bleed from the nose?

If the nose is bleeding, this can also indicate an illness, for example hemophilia. Hypertension, liver disease, leukemia and tumors in the nose and brain are also associated with a bleeding nose.

Liver diseases that cause the nose to bleed are hepatitis, liver dystrophy or life cirrhosis.

Some medications also cause bleeding. Blood thinners such as warfarin and heparin, aspirin and ibuprofen sometimes lead to blood in the front and back of the nose. Excess nasal spray also triggers nosebleeds.

Common suspects among medicines include: antiplatelet agents such as acetylsalicylic acid and anticoagulants, coumarin derivatives and heparins.

Alcohol abuse also causes nosebleeds: alcohol prevents blood from clotting and damages the walls of the blood vessels.

Children often bleed their noses because they drill into their noses and thus directly damage the blood vessels. Sometimes children insert objects into their noses: they can not only injure the nasal mucous membrane, but can also make breathing difficult. Sometimes a doctor has to remove these objects.

On the other hand, nasal tumors, leukemia or deformities of the nose are very rarely the cause of bleeding children's noses - as are various blood disorders. Deformations show up, for example, when the nasal septum deviates from the normal position or has holes.

Chronic sinus infection leads to nosebleeds as well as malformations of the blood vessels or polyps in the nose.

In general, internal diseases that inhibit blood clotting also show up as blood in the nose.

“Wegener's granulomatosis” mostly affects men aged 30 and over. It starts with inflammation in the nose and throat, chronic nosebleed is one of her symptoms.

“Osler's disease” has a genetic basis, the skin vessels also expand in the nasal mucosa. The dilated vessels tear quickly and the nose bleeds.

Symptoms

The main symptom of nosebleeds is blood that runs out of the nose. The blood either comes from both nostrils, or mostly from one. When the blood flow is strong, it fills one nostril and runs over the region that connects both sides of the nose into the other nostril. The blood can also flow back into the throat or down into the stomach. Those affected then spit or vomit blood.

Losing a lot of blood leads to confusion and dizziness. This occurs very rarely with nosebleeds.

Nosebleeds during pregnancy

Nosebleed is common during pregnancy, especially after the first few months. One in five pregnant women bleed their noses, but only one in sixteen women who are not pregnant.

Pregnant women are affected so often because the level of the hormones progesterone and estrogen increases during pregnancy, and this causes the blood vessels to open wider. At the same time, the increased blood pressure drives more blood than usual into the sensitive veins of the nose.

Pregnant women can prevent nosebleeds by drinking plenty of fluids. The more fluid you drink, the less dry the nasal mucous membranes are, which reduces the risk of blood vessels bursting. Breathing through the mouth is also a way to take pressure off your nose.

Gels for the nose moisturize the nasal mucosa, and is the best way to prevent nosebleeds during pregnancy.

A bleeding nose during pregnancy is annoying, but not a reason to worry.

Which cancer causes nosebleeds?

Recurrent or chronic nosebleeds can indicate a far more serious problem - cancer. If the nose bleeds once a month, this is not yet a warning signal.

Constant nosebleed, on the other hand, is one of the symptoms of a tumor in the nasal cavity. The nasal cavity consists of bones and cartilage, blood vessels and connective tissue as well as a skin that covers the cell vessels. Each of these cell types can genetically change to form a tumor.

Blood in the nose is an early symptom of nose cancer, so people with constant bleeding should see a doctor - at this stage, the cancer can be cured relatively well. With nasal cancer, blood usually flows from a nostril.

Nose cancer also often blocks one side of the nose, the nasal mucus becomes more fluid and runs out of the nostril. If the cancer progresses, the sufferers also suffer from visual disturbances and headaches.

Constant nosebleeds can also be a symptom of a completely different cancer - namely leukemia. Leukemia damages white blood cells. Lyphatic leukemia in particular leads to heavy and constant nosebleeds.

Cancer on the lymph nodes causes the lymph nodes in the body to swell. The lymph nodes in the neck and elbows are often the most swollen. This cancer is caused by abnormal white blood cells floating in the lymph nodes. Patients suffering from this cancer bleed profusely from their noses. An important clue is additional blood disorders in other parts of the body.

When do you need to call a doctor?

If you drill intensely in the nose and see blood on your finger at some point, this is no reason to inform a doctor. However, if the nose bleeds suddenly and also violently, call the emergency doctor immediately.

Sufferers need rest because any excitation aggravates the bleeding.

If someone is constantly suffering from a bleeding nose, a systematic examination is necessary. Doctors should not handle it negligent because nosebleeds are usually harmless. However, if the blood flow is strong, it indicates serious illnesses.

Treatment of nosebleeds

Bleeding in the front of the nose can usually be remedied by direct pressure. Medications such as oxymetazoline or neosynephrine help, as does petroleum jelly, which people use to insert a Q-Tip into their nostrils every day. In addition, patients should keep their noses still and avoid any pressure - this includes blowing their nose violently.

Sponges and similarly absorbent material in the nose stop the bleeding, but those affected find it uncomfortable. Medications such as warfarin also have to be inserted into pads in the nose in order to be effective. Those affected then spend a few days in the hospital until the doctor removes the pads and the bleeding stops.

Today, doctors can use modern technology to find and close the wound inside the nose. This direct treatment tops the nosebleed quickly.

Home remedies - wash with hot water

To prevent nosebleeds, keep the nostril under a tap and wash it out with warm to hot water. This is even more effective than the "tampons" that soak up the blood.

Doctors also treat severe bleeding from the nose with this hot conditioner. They first numb the area around the nose, then insert a balloon catheter and rinse the nasal cavity with water at 50 degrees Celsius for three minutes. Most bleeding stops after about ten minutes.

What they can and cannot do

1) Don't bend your head, bend over a sink to catch the blood.

2) Do not swallow the blood, as this can lead to nausea

3) Cool the neck, for example, with moist envelopes

4) Squeeze the nostrils together with only light pressure.

5) Rinse the bleeding nose with warm water.

Prevent nosebleeds

Preventing nosebleeds can be prevented if we blow our nose carefully, gently drill into the nose and avoid fights that could injure our noses.

In addition, in winter, when the heating dries out the air and thus the mucous membranes, we should install humidifiers in the room.

We can use nasal oils, nasal irrigation and nasal ointments that keep the nasal mucous membranes elastic. However, we should be careful with nasal sprays and nasal drops, since both can dry out the nasal mucous membranes in the long term. If we drink a lot, we indirectly moisten our mucous membranes. (Dr. Utz Anhalt)

Author and source information

This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.

Dr. phil. Utz Anhalt, Barbara Schindewolf-Lensch

Swell:

  • Pschyrembel Online: www.pschyrembel.de (access: August 19, 2019), nosebleeds
  • Renee Andreeff: "Epistaxis", in: Journal of the American Academy of PAs, Volume 29 Issue 1, 2016, Ovid
  • Stephanie Yau: "An update on epistaxis", in: Australian family physician, Volume 44 Issue 9, 2015, AFP
  • Samuel Lilienthal: Homeopathic remedies based on clinical criteria, Hahnemann Institute Private Institute for Homeopathic Documentation GmbH, 2017
  • German professional association of ear, nose and throat specialists: www.hno-aerzte-im-netz.de (accessed: 15.08.2019), nosebleeds - causes and risks
  • Johannes W. Rohen; Elke Lütjen-Drecoll: Functional anatomy of humans: a short textbook of macroscopic anatomy according to functional aspects, Schattauer Verlag, 2005
  • Jürgen Strutz: Practice of ENT medicine, head and neck surgery: 275 tables, Georg Thieme Verlag, 2001


Video: What to do during a nosebleed (May 2022).


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