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Nosebleeds - causes, therapy and symptoms

Nosebleeds - causes, therapy and symptoms


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What to do with nosebleeds?

Nosebleeds are sometimes quite dramatic because the blood runs down the face unexpectedly and sometimes in considerable amounts. There are also serious diseases that can be behind the nosebleed, but mostly it is a fairly harmless occurrence. If some behavioral measures are followed in the case of acute nosebleeds, the bleeding can usually be stopped without medical help.

Nosebleeds - the most important facts

In most cases, there is no reason for particular concern with nosebleeds, but this can be frightening for those affected, especially when they first appear and when large amounts of blood appear. In addition, in some cases and in the case of repeated tests, a medical clarification is necessary, as in the worst case there can be serious causes behind the nosebleeds. Here are the most important facts in advance:

  • definition: Nosebleed (epistaxis) describes a sudden discharge of blood from one or both nostrils. Depending on the bleeding source, the epistaxis can also be divided into anterior and posterior bleeding as well as bleeding with direct causes in the nasal area and nosebleed as a result of other diseases.
  • causes: Traumatic injuries due to external force (e.g. broken nose, broken cheekbones, other injuries to the nasal septum and skull base), bleeding of the nasal mucosa due to inflammation and irritation (e.g. due to allergies, contact with toxic substances, dry air, foreign bodies in the nose or the simple Nasal drilling), malformations of the nasal vaginal wall, tumors in the nasal cavity, the paranasal sinuses or the nasopharynx, acute infectious diseases (e.g. measles or flu), high blood pressure, various hereditary diseases, certain autoimmune diseases, an abnormal bleeding tendency, extreme vitamin C deficiency, vitamin K - lack, side effect of medication.
  • Stop nosebleeds: First of all, some immediate measures are required for nosebleeds to avoid unnecessary risks and to stop the bleeding. Sufferers should hang their heads forward in an upright position to facilitate blood drainage. If the head is put back on the neck, the blood is swallowed and, in the worst case, the airways can be blocked by penetrating blood. Squeezing the nostrils for several minutes (in the sitting position) can help stop some forms of nosebleed (e.g. from the Kiesselbachi locus). Cooling wraps around the neck are also recommended as an immediate measure.
  • When to the doctor?: If, despite immediate measures, the nosebleed cannot be stopped after a maximum of 20 minutes (in children after 15 minutes) and / or if there are critical accompanying symptoms (e.g. loss of consciousness or fainting), an emergency room should be visited immediately. This is also necessary in the case of pathological bleeding.
  • Prevent nosebleeds: Avoid dry heating air, avoid toxic substances such as tobacco smoke and allergens, take regular nasal douches, ensure that you have sufficient fluids (water or unsweetened herbal tea) and, if necessary, do without medication that can cause nosebleeds as a side effect.

Nosebleeds: causes of sudden bleeding

Overall, nosebleed is an extremely common symptom, which, according to an American study, occurs more frequently in winter and affects older people more often. Seasonally, nosebleeds were most common in the study group in January and least frequently in September. With regard to the causes of nosebleeds, a distinction must be made between harmless variants and the triggers of the symptoms that require treatment. Repeated occurrence should, however, always be a reason to visit a doctor.

Habitual nosebleed

The medical term for nosebleeds is "epistaxis", comes from the Greek and means "dribble on". In fact, however, the nosebleed often runs violently, so that both affected and observers initially react with a fright.

In most cases, nosebleed is a recurring and harmless phenomenon that affects children in particular and is called "habitual nosebleed". It arises in the anterior nasal septum, where there is a superficial network of vessels. In this so-called “Locus Kiesselbachi”, minor injuries to the blood vessels that cause nosebleeds can occur as a result of external influences, such as heavy blowing or drilling in the nose.

Traumatic causes of nosebleeds

Head injuries and broken bones from falls, blows and accidents often lead to injuries to the nasal septum or skull base and the surrounding blood vessels, causing nosebleeds. The nasal mucosa can also be injured by dry air, exposure to chemical substances or the introduction of foreign bodies into the nose.

Nosebleeds as a symptom of diseases

There are a number of acute infectious diseases that can be associated with nosebleeds, such as the flu or typhoid. However, nosebleeds can also be a symptom of arteriosclerosis, high blood pressure, blood clotting disorders, vascular diseases and an expression of a vitamin deficiency (scurvy, vitamin K deficiency).
After all, nosebleeds can also be the result of various tumors, such as polyps, benign nasopharyngeal fibroma or malignant carcinomas.

Immediate measures for nosebleeds

If nosebleeds occur repeatedly, an otolaryngologist should rule out malignant causes. If it is a one-off or habitual nosebleed, those affected or relatives can usually stop the blood flow independently by taking suitable measures.

The head should not be tilted backwards, otherwise the blood runs down the throat and the inevitable swallowing of the blood often leads to nausea and vomiting. There is also a risk of blood getting into the lungs through the trachea.

It is advisable to sit upright (as this lowers the blood pressure in the head a little), bend the upper body slightly forward and let the head hang forward. In this position, the nostrils can be firmly pressed with the fingers for a few minutes to stop the bleeding. A similar effect can be achieved with a cold stimulus, which is set by placing a cold wrap or a cooling pad in the neck area.

Only with very large blood loss, it is necessary to keep an eye on pulse and blood pressure to avoid shock. The sitting position is also suitable for this because the extent of blood loss can be better observed. If the bleeding cannot be stopped in the manner described, medical attention should be sought as a precaution.

Nosebleeds: medical treatment to stop bleeding

While with the forms of nosebleeds, which are triggered by another illness, the treatment of this illness must be in the foreground, with other forms a symptom-related therapy is possible, which should stop acute bleeding and prevent recurrence. If the source of the bleeding can be clearly located in the front area of ​​the nose, it can be obliterated with an acid etching or with electro- or laser coagulation. The nasal cavity is then treated.

If the bleeding source cannot be localized immediately or the bleeding cannot be stopped by sclerotherapy, it is possible to insert a tamponade made of ointment-soaked gauze strips or foam. This must always be done on both sides in order to create sufficient pressure on the blood vessels and to avoid one-sided pressure on the nasal septum. A similar effect can also be created using an inflatable silicone balloon catheter. If there is so-called posterior nosebleed, a special tamponade (posterior tamponade) can also be placed, with the operation being performed under anesthesia.

In the event of heavy bleeding that cannot be stopped using the methods mentioned, the supplying vessels can be embolized to prevent the bleeding. For example, some forms of nosebleed can only be successfully treated by surgery.

Naturopathy for nosebleeds

From the perspective of naturopathy, the (conventionally often performed) obliteration of blood vessels in the nasal mucosa should be assessed rather critically, because the bleeding - like every reaction of the body - is attributed to a function and feared a shift in symptoms.

Once the nosebleed has been clarified by a doctor and malignant causes are excluded, various naturopathic treatments can relieve nosebleeds. From the field of herbal medicine, nasal rinsing with horsetail or oak bark extract for nosebleeds, for example, is worth trying. A mixture of cold water, vinegar and lemon can also be drawn into the nose.

Holistic medicine

Homeopathy in particular provides some hemostatic agents that promise relief from nosebleeds. If the bleeding is caused by an injury to the nasal mucosa or by great physical exertion, arnica can help. Also after exertion, but especially with nosebleeds after blowing your nose and sneezing, phosphorus can be the right remedy. If violent excitement (fear, excitement) plays a role in the cause, it may be worth trying Aconitum. If there is a tendency to repeat nosebleeds, it is also possible to have constitutional treatment carried out in a practice for homeopathy.

In acute cases, the emergency drops from Bach Flower Therapy, which are also available as an ointment for local application, can alternatively be tried out for internal use. (jvs, fp)

Also read:
Nosebleeds: symptom of a blood clotting disorder

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.

Swell:

  • Stephanie Yau: An update on epistaxis, in Australian Family Physician, Volume 44, No.9, September 2015, pages 653-656, PubMed
  • Andreeff, Renee: Epistaxis; in Journal of the American Academy of PAs: January 2016, Volume 29, Issue 1, pages 46-47, JAAPA
  • Otolaryngologists online: nosebleeds - first aid (available on August 20, 2019), hno-aerzte-im-netz.de
  • R. Purkey, Matthew; Seeskin, Zachary; Chandra, Rakesh: Seasonal Variation and Predictors of Epistaxis. The Laryngoscope, 124 (9), September 2014, PubMed


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