Epistaxis is the loss of blood from the tissue that lines the inside of your nose. Because of the position of the nose – right in the middle of the face and its high density of blood vessels, most of us will have had atleast one nosebleed at sometime during our lives. Nosebleeds are common. Some 60% of people will have at least one nosebleed in their lifetime.
Although seeing blood coming out of your nose can be alarming, most nosebleeds are not serious and can be managed at home. Some, however, should be checked by the doctor. A few nosebleeds start in the back of the nose. These nosebleeds usually involve large blood vessels, result in heavy bleeding and can be dangerous. You will need medical attention for this type of bleed, especially if the bleeding occurs after an injury.
The main symptom of a nosebleed is blood coming from the nose, which can range from light to heavy. The blood comes out of either nostril (usually, only one nostril is affected).
If the nosebleed occurs while lying down, it is common to feel liquid in the back of the throat before the blood comes from the nose. It is best not to swallow the blood as it could cause feeling of nausea and vomiting.
Severe nose bleeds require immediate medical attention. Some more things to watch for includes-
• Heavy bleeding
• Swallowing large amount of blood that causes vomiting
• Shortness of breath
• Turning pale
• Palpitations (an irregular heartbeat)
Dry air is the most common cause of nosebleeds. Living in a dry climate and using a central heating system can dry out the nasal membranes, which are tissues inside the nose.
This dryness causes crusting inside the nose. Crusting may itch or become irritated. If your nose is scratched or picked, it can bleed.
Taking antihistamines and decongestants for allergies, Cold or sinus problems can also dry out the nasal membranes and cause nosebleeds.
Frequent nose blowing is another cause of nosebleeds.
Other common causes of nosebleeds include –
• Foreign object stuck in the nose
• Chemical irritants
• Repeated sneezing
• Cold air
• Upper respiratory infection
• Allergic reaction
• Injury to the nose
• Larger doses of aspirin
Other causes of nosebleeds includes –
• Blood clotting disorders
• High blood pressure
• Bleeding disorders
There are two main types and one is more serious than the other.
• Anterior nosebleed
It starts in the front of the nose on the lower part of the wall that separates the to sides of the nose (called septum). Capillaries and small blood vessels in this front area of the nose are fragile and can easily break and bleed. This is the most common type of nosebleed and is usually not serious. These nosebleeds are more common in children and usually able to be treated at home.
• Posterior nosebleed
It occurs deep inside the nose. This type of nosebleed is caused by a bleed in larger blood vessels in the back part of the nose near the throat. This can be a more serious nosebleed than an anterior nosebleed. It can result in heavy bleeding, which may flow down the back of the throat. Patient may need medical attention right away for this type of nosebleed. This type of nosebleed is more common in adults.
There is no single test to determine the cause of a nosebleed. After conducting physical examination determine the cause of epistaxis , you doctor might use some diagnostic test to confirm the cause of diagnosis. These tests include –
• Complete blood count (CBC)
• Partial thromboplastin time (PTT)
• Nasal endoscopy
• CT scan of the nose
• X-ray of the face and nose
The first step is to stop the bleeding –
• Sit down and pinch the soft parts of the nose firmly, breathe through the mouth.
• Lean forward to prevent blood from draining into the sinuses and throat, which can result in inhaling the blood or gagging.
• Sit upright so that the head is higher than the heart ; this reduces blood pressure and slows further bleeding.
• Continue putting pressure on the nose, leaning forward and sitting upright for a minimum of 5 minutes and upto 20 minutes, so that the blood clots.If bleeding persists for more than 20 minutes, medical attention is required.
• Apply an icepack to the nose and cheek to soothe the area and avoid sternous activity for the next few days.
There is an array of treatment options physicians have to offer, which includes –
• Nasal Packing
It is the procedure of sstuffing ribbon gauze or special nasal sponges as far back into your nose as possible, putting pressure on the source of the bleed.
It is a minor procedure that cauterizes (burn) the area where the bleeding is coming from to seaI it off, this is used if the specific blood vessel Can be identified. However, the area around the cautery sometimes begins to bleed.
• Septal surgery
It is a surgical procedure to straighten a crooked septum, whether it was like that from birth or from an injury. This can reduce the occurrence of epistaxis.
It is a “lastresort” surgical procedure that involves tying the ends of the identified blood vessels causing the bleeding. If the problems still comes back, more major surgery may be required.
There are several ways to prevent epistaxis.
• Use a humidifier in your house to keep the air moist.
• Use a saline spray or gel to keep the nasal passages moist.
• Use antihistamines and decongestants in moderation. Then can dry out the nose.
• Limit your intake of aspirin, which can thin your blood and contribute to nosebleeds.
• Avoid picking your nose.
• To prevent recurring episodes of epistaxis, avoid exertion or sternous activity for a minimum of 1 week after the previous nosebleed.
Ayurvedic Perspective –
According to Ayurveda, an imbalance of pitta dosha is the main cause of the Epistaxis It is explained as Nasagata Raktopitta in Ayurveda. Nasagata Raktapitta is a type of Urdhwaga Raktapitta.
Nasal drops for nose bleeding
• Durva rasa
• Draksha rasa
• Ikshu rasa
• Cow’s milk
• Palandu (Onion) mula rasa
• Priyala taila nasayam
• Pomegranate nose drops
• Apple cider vinegar
• Anu taila
• Bel rasa
• Kaharva Pisti
• Moti Pisti
• Kamdugdha Rasa
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