One-Sided Nosebleeds: When to See an ENT Specialist - Internal Medicine

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When it comes to understanding one-sided nosebleeds, especially in the context of your symptoms, it is essential to consider several factors before deciding whether to see an ENT specialist or pursue further evaluation for potential head injuries.

Firstly, the fact that your nosebleed occurs on one side and resolves within about two minutes is noteworthy. Typically, unilateral nosebleeds can be caused by localized issues such as nasal trauma, dry air, or structural abnormalities like a deviated septum, which you mentioned having. The presence of thick, viscous blood rather than pure blood can indicate that the bleeding is originating from a specific area in the nasal cavity, potentially involving mucosal irritation or inflammation.

The additional symptom of blood in your phlegm after the nosebleed raises some concern. This could suggest that the bleeding might not be limited to the nasal passages but could involve the throat or even the lungs, especially if there has been significant irritation or trauma. However, it is also possible that this blood is simply residual from the nasal bleeding, particularly if you have been coughing or clearing your throat.

Your history of multiple head impacts is particularly relevant. Head trauma can lead to various complications, including nasal fractures, which could contribute to recurrent nosebleeds. While a single episode of a nosebleed may not be alarming, recurrent episodes, especially following trauma, warrant further investigation. The slight dizziness you experience after the nosebleed could also be a sign of a more significant issue, such as a concussion or other intracranial injury, particularly if it is accompanied by other symptoms like headaches, confusion, or visual disturbances.

Given these considerations, it is advisable to consult with an ENT specialist. They can perform a thorough examination of your nasal passages and assess for any structural issues, such as your deviated septum, that may be contributing to the bleeding. They may also recommend imaging studies, such as a CT scan, to evaluate for any underlying injuries related to your head trauma.

In summary, while your unilateral nosebleed may not seem severe, the combination of symptoms—including the nature of the bleeding, the presence of blood in your phlegm, and your history of head trauma—suggests that further evaluation is warranted. An ENT specialist can provide targeted care for your nasal issues, while a neurologist or other specialist may be necessary to assess any potential complications from your head injuries. It is always better to err on the side of caution, especially when it comes to symptoms that could indicate more serious underlying conditions.