Ear and Nose Bleeding: Causes and When to Seek Help

Bleeding from the ears and nose?

Hello Dr.
Cheng, thank you for taking the time to respond.
My mother experienced a sensation of ear blockage yesterday, and later discovered some bleeding in her ear through a tissue.
The bleeding was not severe enough to flow out but had a darker color, similar to that of povidone-iodine.
Today, when she blew her nose, there was also blood in her mucus, more than just streaks, and sometimes she feels like there are dried blood clots.
Additionally, her ear continues to bleed today (similar to before, only noticeable when wiped with tissue or a cotton swab).
I would like to ask if the bleeding from both the ear and nose could be related, and whether it is necessary to seek medical treatment, or if medication could help alleviate the symptoms.
My mother is around 50 years old, and I suspect the bleeding may be due to two reasons: (1) She has chronic nasal congestion and frequently blows her nose due to past illnesses, which sometimes causes nosebleeds from excessive force.
(2) For the past few months, she has felt a sensation of fluid in her ear, but several ENT specialists have been unable to identify the cause, so it is possible that she may have caused the bleeding by digging in her ear too forcefully.
Since my mother is part of a high-risk group for pneumonia, she is very reluctant to visit a medical facility.
After much persuasion, I am left with no choice but to inquire about these issues.
I sincerely apologize for this.
Lastly, thank you again for your assistance, and I wish you good health and safety.
Thank you.

Mr. Chen, 20~29 year old female. Ask Date: 2021/06/09

Dr. Zheng Jueyi reply Otolaryngology

Hello, if you have persistent nasal discharge with blood streaks accompanied by unilateral ear fullness, it is recommended to seek medical evaluation to assess the condition of the nasopharynx.
If the symptoms are due to nasal allergies affecting the function of the Eustachian tube, medications or nasal sprays may be used to manage and improve the condition.
Wishing you safety and health.
Sincerely, Dr.
Cheng Jue-Yi, Director of the Department of Otolaryngology, Taoyuan Hospital, Ministry of Health and Welfare.

Reply Date: 2021/06/09

More Info

Understanding the relationship between ear and nose bleeding is crucial, especially in the context of your mother's symptoms. The presence of blood in both the ear and nasal passages can indeed be interconnected, and it is important to consider various underlying causes.

Firstly, the ear and nose are anatomically linked through the Eustachian tube, which connects the middle ear to the nasopharynx. This connection means that issues in one area can often affect the other. For instance, nasal congestion or inflammation can lead to Eustachian tube dysfunction, which may cause a feeling of fullness or pressure in the ear. This dysfunction can also lead to fluid accumulation in the middle ear, which might explain your mother's sensation of ear fullness and potential bleeding.

The bleeding in your mother's ear could be attributed to several factors. One possibility is trauma to the ear canal, which can occur from aggressive cleaning with cotton swabs or fingers. This can lead to abrasions or even small lacerations, resulting in bleeding. Additionally, if she has been experiencing fluid buildup in her ear, this could lead to increased pressure and potential rupture of small blood vessels, causing bleeding.

On the other hand, the nasal bleeding could be due to several reasons, particularly if your mother has a history of nasal congestion and frequent nose blowing. Forceful nose blowing can cause small blood vessels in the nasal mucosa to rupture, leading to epistaxis (nosebleeds). Chronic nasal congestion, possibly due to allergies or sinusitis, can also contribute to this issue.

Given your mother's age and her history of pneumonia, it is crucial to approach this situation with caution. While it might be tempting to manage these symptoms at home, the persistence of bleeding from both the ear and nose warrants a medical evaluation. It is essential to rule out any serious underlying conditions, such as infections or structural abnormalities.

In terms of treatment, if the bleeding is minor and there are no signs of infection (such as fever, severe pain, or discharge), conservative management may be appropriate. This could include using saline nasal sprays to keep the nasal passages moist, avoiding forceful nose blowing, and refraining from inserting anything into the ear canal. Over-the-counter medications, such as antihistamines or decongestants, may help alleviate nasal congestion, but they should be used with caution and ideally under the guidance of a healthcare provider.

However, if the bleeding continues, increases in severity, or is accompanied by other concerning symptoms (such as significant pain, hearing loss, or fever), it is imperative to seek medical attention promptly. An ear, nose, and throat (ENT) specialist can perform a thorough examination, potentially including imaging studies, to determine the underlying cause and appropriate treatment.

In summary, while there may be a relationship between your mother's ear and nose bleeding due to anatomical connections and potential shared causes, it is essential to approach this situation with care. Given her medical history and the persistence of symptoms, a visit to a healthcare provider is strongly recommended to ensure her health and safety.

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