What is epistaxis?
Epistaxis (nosebleed) is the medical term for bleeding from the nose, nasal cavity, or nasopharynx. It is a common occurrence in patients of all ages, although the causes can vary widely. Most nosebleeds are minor and can be controlled at home; however, in certain patients, the bleeding may persist requiring treatment in the emergency room.
What causes epistaxis?
Most episodes of epistaxis come from an area in the anterior nasal septum called Kiesselbach’s Plexus, or Little’s Area. Several different arteries come together in this area, making the blood supply dense and prone to bleeding. Less commonly, bleeding can come from the nasal turbinates or from the posterior nasal cavity near the sphenopalatine artery.
In children, the most common cause of epistaxis is digital trauma, or nose picking. In adults, epistaxis is more commonly caused by high blood pressure or blood thinning medications. Other causes affecting patients of all ages include allergies, sinus infections, environmental conditions like dry weather or high altitudes, systemic medical conditions, bleeding disorders, or nasal tumors.
Treatment of Epistaxis
The best treatment of epistaxis is preventative measures, primarily addressing the underlying cause of the nosebleeds. If high blood pressure is the cause, starting anti-hypertensive medication or adjusting existing medication should be discussed. Easy bleeding is a side effect of many blood-thinning medications. If a patient is experiencing recurring nosebleeds while on a blood thinner, they should discuss switching the medication or stopping it for short period of time in order for the nose to heal.
Home remedies help to keep the nose and nasal lining moist. Using nasal saline spray or a saline-based ointment is an option. Also, especially during the wintertime or in high altitudes, a bedside humidifier at night can help put moisture back into the air.
The first treatment for an active nosebleed is to hold constant pressure on the entire nose for at least 10-15 minutes. A nasal decongestant spray such as oxymetazoline or phenylephrine can be used to help constrict the nasal blood vessels. If these steps do not stop the bleeding, a patient should seek further medical attention in the emergency room. Here, medications can be given and nasal packing can be inserted to help stop the bleeding.
For those experiencing recurring nosebleeds, your doctor may recommend nasal cauterization of the affected blood vessels. This is most commonly done in the office under local anesthesia using silver nitrate. If this is unsuccessful, cauterization in the operating room under general anesthesia as an outpatient procedure may be necessary.