Nose Bleeds

Nose bleeding is one of the most common complaints in the ENT field. Almost everyone has had a nosebleed at least once in their life. Although it is a condition that is usually due to simple causes and is easily stopped, sometimes the cause can be very serious and life-threatening severe bleeding.

Why Does the Nose Bleed Often?
The nose contains very dense and superficial veins. Particularly, the front part of the partition that divides the nasal cavity into two is a section where the vessels coming to the nose merge with each other and these vessels are quite superficial. Especially in children, this part can bleed even without any effect. The meat called concha located on both sides of the nasal cavity is very rich in veins and is the cause of some bleeding.

What are the Causes of Nose Bleeding?
Nose bleeding develops due to both nasal causes (local causes) and problems outside the nose (general causes).

Local Causes:
-Intranasal inflammations

-Sinusitis
-Blows to the nose
-Children’s nose picking
-Foreign objects inserted into the nose
-Intranasal and sinus tumors
– Bone curvature in the nose (septum deviation)
-Allergic rhinitis

General Reasons:
-Hypertension
-Blood Diseases (Bleeding-coagulation disorders, leukemia, etc.)
-Intestinal Parasites

What Examinations Need to be Performed?

Especially in severe nosebleeds, the first thing to do is to stop the bleeding regardless of the cause. After the bleeding is stopped, some research should be done on the cause. The first thing to do in investigating the cause is the examination of the patient. Many times, the reason can be understood by examination. Investigations that can be done according to the suspected cause are as follows:
-Measuring blood pressure
-Sinusitis films (normal films or tomography)
-Intestinal parasite investigation
-Bleeding-Coagulation tests
-Tests for blood diseases
These tests are not always applied to every patient. According to the reason suspected by the doctor, some of them are done and the cause is tried to be found.

How Is It Treated?
Many nosebleeds stop spontaneously or with the patient holding the tip of the nose and applying cold. However, bleeding that does not stop in this way requires doctor intervention. Interventions to stop bleeding include:

– Burning the vein:
It is used for mild, recurrent bleeding. It is tried to prevent bleeding by applying chemical substances to the vascular network in the anterior part of the nasal chamber. There is a risk of perforation of the nasal chamber when applied to both sides or excessive use of chemicals.

-Placing the Pad:
It is a common treatment method. It is used for bleeding that cannot be stopped by holding the tip of the nose or applying cold. The tampon placed in the nasal cavity stops the bleeding by putting pressure on the bleeding vessel.

As a tampon, gauze with antibiotic creams can be used, as well as more comfortable tampons with a tube in the middle that will allow the patient to breathe. Tampons are usually removed after 48 hours.

Longer exposure can sometimes lead to problem infections. It should not be neglected to give antibiotics to the patient during the buffer period. Sometimes the source of nosebleeds is the posterior parts of the nose and cannot be stopped with tampons placed from the front. In this case, the so-called posterior (poster) tampon is used, which is inserted through the mouth and placed on the back of the nose.

Ligation of Veins:
This procedure is an operation and is used for bleeding that is severe enough to threaten the patient’s life and that does not stop with tampon insertion. The vein, which is determined according to the location of the bleeding, is sometimes connected through the sinus and sometimes by opening the neck. Relief of the patient during the interventions to the patient has an important place. For this purpose, especially in elderly and hypertensive patients, it may be necessary to administer diazem or other sedative drugs to the patient.

What Can I Do At Home When My Nose Bleeds?
Many times, the patient’s own methods can stop the bleeding. The first thing the patient should do is hold the tip of the nose tightly and tilt the head forward.

If the head is tilted backwards, the chance of blood flowing from the nose to the throat increases. Cold application on the nose is also beneficial. The patient can even put a gauze pad on the front of the nose to act as a buffer.

However, even if the patient’s own methods stop the bleeding, an ENT specialist should be examined at the appropriate time.

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