Nosebleeds and Sinus Issues: Common ENT Concerns

Regarding nasal issues?

Hello Dr.
Zheng, I would like to ask you a few questions.

1.
Occasionally, when I brush my teeth in the morning, I suddenly experience a nosebleed from the left side.
Could this be due to brushing too hard?
2.
I have a history of allergic rhinitis and post-nasal drip.
Recently, after catching a cold, my doctor mentioned that I have a nasal deviation.
Is this deviation related to my nosebleeds?
3.
The clinic doctor said that if the deviation is severe, surgery may be necessary.
After the surgery, will I no longer experience nosebleeds or post-nasal drip?
4.
If I perform nasal irrigation, will it improve my symptoms? Initially, I only had nosebleeds on the left side, but now the right side is also bleeding.
Currently, I rarely blow my nose, and I would like to know if I should visit a small clinic or if I need to go to a larger hospital for further examination.

Thank you for your patient response, and I appreciate your help.

Xiao Qiao, 20~29 year old female. Ask Date: 2015/01/27

Dr. Zheng Jueyi reply Otolaryngology

Hello, the most common cause of nosebleeds is the rupture of microvessels in the anterior nasal vestibule.
If you have allergic rhinitis, frequent nose blowing may lead to bleeding.
As for a deviated septum, it primarily causes nasal congestion and is not necessarily directly related to bleeding.
It is recommended to avoid nasal irrigation for the time being and to apply petroleum jelly or other ointments to aid in healing.
If bleeding persists, you should seek treatment at a clinic.
However, if there is no improvement, you may discuss with your clinic physician the need for referral or further treatment.
Wishing you safety and health.
Sincerely, Dr.
Jue-Yi Cheng, Director of the Department of Otolaryngology, Taoyuan Hospital, Ministry of Health and Welfare.

Reply Date: 2015/01/27

More Info

Nosebleeds, medically known as epistaxis, can be a common concern, especially for individuals with underlying conditions such as allergic rhinitis or structural abnormalities in the nasal cavity. Let's address your questions one by one.

1. Nosebleeds During Brushing: It's possible that brushing your teeth too vigorously could contribute to nosebleeds, especially if you're inadvertently applying pressure to the nasal area or if you're bending over while brushing. However, if this is a recurring issue, it may be more related to the dryness of your nasal mucosa or other underlying factors rather than just the act of brushing.

2. Nasal Deviation and Bleeding: The "bending" or deviation of the nasal septum can indeed be related to your nosebleeds. A deviated septum can cause uneven airflow and pressure in the nasal passages, leading to irritation and dryness, which can make the blood vessels in your nose more susceptible to bleeding. If you have allergic rhinitis, the inflammation and congestion can further exacerbate this issue.

3. Surgery for Deviated Septum: If your doctor has recommended surgery due to a severe deviation, it is typically aimed at improving airflow and reducing symptoms such as frequent nosebleeds and sinus infections. While surgery can significantly improve your nasal function and potentially reduce the frequency of nosebleeds, it does not guarantee that you will never experience them again. Post-operative care and management of underlying conditions like allergies are crucial for long-term success.

4. Nasal Irrigation: Washing your nose, or nasal irrigation, can be beneficial for managing symptoms associated with allergic rhinitis and sinus issues. It helps to clear out mucus, allergens, and irritants from the nasal passages, which can reduce inflammation and improve overall nasal health. This practice can also help keep the nasal mucosa moist, potentially reducing the likelihood of nosebleeds.

Regarding your current situation, since you are experiencing nosebleeds on both sides now, it would be prudent to consult with a healthcare professional. A visit to a larger hospital or an ENT specialist may be warranted, especially if the nosebleeds are frequent or if you have other concerning symptoms. They can perform a thorough examination, possibly including imaging studies, to assess the structure of your nasal passages and determine the best course of action.

In summary, while occasional nosebleeds can be benign, persistent or recurrent episodes warrant further investigation, especially in the context of allergic rhinitis and nasal structural issues. Managing your allergies effectively, considering nasal irrigation, and following up with a healthcare provider can help improve your symptoms and quality of life.

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