Recurrent Nosebleeds: Causes and Treatments

Nasal vestibule

Hello Doctor, I have been experiencing recurrent nosebleeds since last Sunday.
I recall having three or four episodes last week.
One instance occurred early in the morning when I woke up, and there was blood around my right nostril.
Another time was during lunch when I was chewing and suddenly felt a wound open up, causing a significant amount of blood to flow, but it stopped quickly.
I visited a general clinic where they noted a wound and provided medication and ointment.
I have finished the medication, but I am still using the ointment, and the issue has not resolved.
I then went to another clinic where they mentioned that a capillary had ruptured and advised me to apply pressure until the bleeding stops.
They provided medication but no ointment.
I finished the medication, but I still experience nosebleeds.
On January 9th, I woke up to find blood around the inside of my right nostril again.
Yesterday, while applying the ointment gently, blood started to flow again.
I experienced another nosebleed today, but each time, applying slight pressure stops the bleeding.

A Yuan, 20~29 year old female. Ask Date: 2023/01/11

Dr. Li Jiaxuan reply Otolaryngology

Generally, it is important to first confirm whether there is a coagulation disorder through blood tests.
Additionally, it is essential to check for mucosal or vascular injuries, as well as to identify any non-traumatic causes of bleeding.
It is recommended to seek medical attention for further evaluation.
Wishing you good health.

Reply Date: 2023/01/11

More Info

Recurrent nosebleeds, also known as epistaxis, can be a frustrating and concerning issue for many individuals. Understanding the potential causes and appropriate treatments is essential for managing this condition effectively.

Causes of Recurrent Nosebleeds
1. Dry Air: One of the most common causes of nosebleeds is dry air, particularly in winter months or in arid climates. Dryness can lead to the cracking of the nasal mucosa, making it more susceptible to bleeding.

2. Nasal Trauma: Any injury to the nose, whether from picking, blowing, or even a minor bump, can cause bleeding. In your case, you mentioned that you experienced bleeding after biting down on food, which could indicate that the pressure caused a rupture in a blood vessel.

3. Underlying Health Conditions: Conditions such as hypertension (high blood pressure), blood clotting disorders, or even certain medications (like anticoagulants) can increase the likelihood of nosebleeds. If you have any underlying health issues, it’s important to discuss these with your healthcare provider.

4. Allergies and Infections: Allergic rhinitis or sinus infections can lead to inflammation and irritation of the nasal passages, which may contribute to bleeding.

5. Structural Issues: Deviated septum or other anatomical abnormalities in the nasal passages can predispose individuals to recurrent nosebleeds.

Treatments for Recurrent Nosebleeds
1. Moisturizing the Nasal Passages: Using saline nasal sprays or applying a thin layer of petroleum jelly inside the nostrils can help keep the nasal mucosa moist and reduce the risk of bleeding.

2. Avoiding Irritants: Stay away from smoke, strong odors, and other irritants that can dry out or irritate the nasal passages.

3. Proper Nosebleed Management: When a nosebleed occurs, it’s important to remain calm. Pinch the nostrils together and lean slightly forward to prevent blood from flowing down the throat. Maintain this pressure for about 5-10 minutes. If bleeding persists, seek medical attention.

4. Cauterization: If you have persistent bleeding from a specific site, a healthcare provider may recommend cauterization, a procedure that uses heat or chemicals to seal the blood vessels.

5. Addressing Underlying Conditions: If your nosebleeds are linked to a medical condition, treating that condition may help reduce the frequency of nosebleeds. For example, managing blood pressure or adjusting medications may be necessary.

6. Consultation with a Specialist: If nosebleeds continue despite home management strategies, it may be beneficial to consult an ear, nose, and throat (ENT) specialist. They can perform a thorough examination and may recommend further treatments or interventions.

Conclusion
Recurrent nosebleeds can often be managed effectively with simple home care strategies, but persistent or severe cases warrant further investigation. Given your recent experiences, it’s advisable to keep track of the frequency and circumstances surrounding your nosebleeds. If they continue or worsen, consider seeking a second opinion or further evaluation from a specialist. Remember, while nosebleeds can be alarming, they are often manageable with the right approach.

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