Symptoms, causes and treatment of nosebleeds

Nosebleeds (nosebleeds) are a fairly common pathological condition in the ear, nose and throat area. Although nosebleeds are not life-threatening, they can easily cause panic and worry in patients and their families.

1. Causes of nosebleeds

Causes of nosebleeds can be both local and systemic.

On-site:Due to infections such as acute rhinitis, chronic rhinitis, bacterial rhinitis, viral rhinitis; acute sinusitis; vasomotor rhinitis; allergic rhinitis. Due to trauma from nose picking or foreign objects entering the nose (common in children); nasal stones in both adults and children; lesions causing nasal ulcers commonly found in chemical workers when protection is not good, due to tuberculosis, syphilis or leprosy. Due to abnormal structures in the nasal cavity such as crooked or thorny nasal septum. Due to tumors: benign such as nasopharyngeal fibroma, fungal tumors and malignant tumors such as nasopharyngeal cancer, nasal cavity tumors, sinus tumors, skull base tumors.

Whole body:Acute systemic diseases causing initial blood clotting disorders such as influenza, severe measles, scarlet fever, dengue fever, malaria... Cardiovascular diseases such as high blood pressure; ruptured aneurysms of the vascular system, carotid artery; atherosclerosis. Blood system diseases occur in people with severe anemia, toxic infections, vitamin deficiencies; acute leukemia; bone marrow failure; thrombocytopenia of unknown cause, platelet quality disorders, and vascular diseases such as hemophilia.

Some other causes include hormonal changes in the body of pregnant women, those who are menstruating, or those who use nasal corticosteroid sprays for a long time without proper indications, or those who use anticoagulants; changes in atmospheric pressure, changes in weather...The remaining 5% have no known cause (idiopathic), often occurring in adolescence, with spontaneous bleeding in small amounts, recurring many times, and often occurring when working hard or being out in the sun for too long.

Because the nose is located in a special position (in the middle of the face) and has many blood vessels, many people occasionally experience nosebleeds. Nosebleeds come from many different causes.

Allergic rhinitis:As a result of your body's allergic reaction, the tissues lining your nose swell. The capillaries dilate and sometimes burst, causing bleeding. Blood may ooze out in small streaks whenever you blow your nose or sneeze.

You should get tested for allergies to find out what you might be allergic to so you can take appropriate precautions, such as taking anti-allergy or decongestant medications.

Severe dry climate:This is common in patients with a deviated septum because the airflow 'passes' through a narrow area in the nose more quickly and dries out the nose. This causes irritation, followed by sneezing and nosebleeds.

Frequent sneezing:Frequent sneezing can also cause ulcers in the lining of the septum (the central partition between the two nostrils) and this can easily lead to bleeding.

Nosebleeds in children are usually caused by broken or ulcerated blood vessels on the front of the nasal septum, which is usually caused by a cold or sneezing. This can be controlled by helping the child to limit sneezing by keeping the nose moist (you can lubricate the nose with oils such as coconut oil or olive oil).

Nose picking:Picking your nose is a seemingly harmless activity, but in reality it can cause nose hair loss, damage the mucous membrane, rupture blood vessels and cause bleeding. In addition, frequent nose picking can easily cause nasal infections. The habit of nose picking should be abandoned because it can weaken the protective function of the nasal cavity, causing more nosebleeds.

Hypertension:High blood pressure is a common cause of nosebleeds in the elderly. When blood pressure increases, it leads to increased pressure on the blood vessel walls, which can rupture the blood vessel walls, leading to dangerous complications such as nosebleeds, cerebral hemorrhage, heart failure, aortic dissection, retinal hemorrhage causing permanent blindness...

Physiological changes:Physiological changes that lead to nosebleeds are common in pregnant women, especially those with high blood pressure during pregnancy. In this case, pregnant women should consult an obstetrician to know how to cope and treat the disease.

Vitamin C deficiency:Vitamin C is one of the antioxidants that increases resistance, protects blood vessels and supports the absorption of iron and calcium. When lacking vitamin C, the skin will be dry, prone to subcutaneous bleeding (skin is easily bruised when lightly touched), nosebleeds, bleeding gums, and slow wound healing. Therefore, when teenagers suddenly have nosebleeds, it can "signal" that the body is in dire need of additional vitamin C.

Acute and chronic rhinitis:Rhinitis causes the mucus layer that protects the surface of the nasal mucosa to be damaged, so the blood vessels located right below are often scratched and torn, causing nosebleeds. The secretions that are often secreted when the nose is inflamed stick to the mucosal layer, making you feel itchy and uncomfortable. This leads to frequent nose picking, causing nosebleeds.

Nasopharyngeal fibroma:This is a fairly common disease in puberty but is more common in teenage boys than teenage girls. Nosebleeds are one of the symptoms of the disease, accompanied by signs such as: teenagers have a continuous runny nose, increasing nasal congestion on one side, tinnitus and hearing loss due to the tumor pressing on the Eustachian tube area, and the person is thin, pale, and tired.

Foreign body in nose:In many cases, foreign objects stuck in the nose cause you to often have headaches and nosebleeds without knowing the cause.

2. Symptoms and signs of nosebleeds

Blood usually flows from only one side of the nose. If there is a lot of blood, it can fill one side of the nose and spill into the nasopharynx (the area inside the nose where the two nostrils meet), causing bleeding from the other side as well.Blood may also drip into the back of the throat or down into the stomach, causing the patient to spit or even vomit blood.

Signs of excessive blood loss include:Dizziness, Weakness, Confusion, Fainting, Severe blood loss due to nosebleeds rarely occurs.

3. Prevent nosebleeds

- Learn about nosebleeds

- Explain to children that they should not pick their nose because besides causing nosebleeds, this is also a cause of infection in the nose and throat area.

- When seeing a child showing signs of a nosebleed, parents should instruct the child to calmly sit down or lie down (if possible), then use two fingers to tightly close both nostrils and breathe gently through the mouth for 5 to 10 minutes to stop the bleeding.

- There are many other causes of nosebleeds, so when children have unusual nosebleeds many times, they should be examined and treated at facilities with specialized ENT clinics to find the cause and thoroughly treat the nosebleeds.

- In addition, parents can use saline (diluted salt water) to clean the nose twice a week. Do not use saline too many times because it will cause the nasal mucosa to lose its protective mucus layer and become vulnerable.

4. Treatment of nosebleeds

When dealing with a patient with a nosebleed, the first thing to do is to stop the bleeding, then find the cause. In cases of severe bleeding, attention must be paid to the patient's general condition (closely monitor pulse and blood pressure).

Systemic treatment

- Let the patient rest quietly, sit or lie with head elevated, open mouth to spit out blood.

- Infusion if there is circulatory collapse, blood pressure.

- Blood transfusion if Hb drops below 50%, blood transfusion is an active measure, especially in cases of severe bleeding, it is best to transfuse small doses of fresh blood (100ml) many times.

- Corticoids: If there are no contraindications to corticosteroid use, most authors believe that the use of corticosteroids in bleeding is necessary, usually intravenous injection such as depersolone.

- Antibiotics: Prevent stagnant secretions from causing infection in the nose and surrounding areas.

- Coagulants: Increase vascular wall strength, reduce bleeding time such as Adrenoxyl, Premarin... or directly clot blood such as vitamin K, protamine sulfate.

Local treatment

- Local hemostasis is performed from simple to complex according to the following steps:

- Press the nostrils against the nasal septum: Use two fingers to gently squeeze the nostrils against the septum corresponding to the Kisselbach pulse point for a few minutes, applied in cases of light bleeding, bleeding at the Kisselbach pulse point.

- Hemostatic solution: Use cotton soaked in hemostatic solution such as 12 volume hydrogen peroxide, 1-3% ephedrine to press on the bleeding area.

- Silver nitrate pearl (AgNO3): Use a blunt-tipped pin, heated red at the tip, dip it into 5% concentrated silver nitrate solution, the silver salt will flow out and condense into a small, shiny bead at the tip of the pin, press the pearl against the bleeding area.

- Cover the nose and leave it on for about 48-72 hours, during which time antibiotics must be used.

According to khoahoc.tv