Epistaxis – All You Need To Know


Epistaxis, also known as acute hemorrhage or nose bleed, is a medical condition characterized by bleeding from the nostril’s nasal cavity. A nose bleed may occur as a result of a blow to the nose, an accident, or a pricking injury to the interior of the nose.


“The root of nosebleed or epistaxis may be categorized as anterior or posterior, depending on where it starts. Anterior nosebleeds are normal and do not need medical treatment, whereas posterior nosebleeds are unusual and need urgent medical attention.”- Says Dr. Pradeep who is a Visakhapatnam based ENT specialist. He also added that epistaxis is a disease that affects both children and the elderly.

Signs and Symptoms

The bleeding normally begins in one nostril. Heavy bleeding may cause both nostrils to fill up and the nasopharynx to overflow. Blood can drip back from the nose through the throat and into the stomach in some cases. In this case, a person is likely to vomit. Excessive blood loss can cause dizziness, fainting, confusion, loss of alertness, and light-headedness,

among other symptoms. The disorder is, however, uncommon according to the ENT specialists.

Bleeding from other areas of the body, such as the teeth, gums, and nostrils, indicates that the blood is unable to clot.

Additional bleeding from other areas of the body, such as bleeding gums while brushing teeth, blood in urine or bowel movements, or easy swelling, may also be signs of a blood clotting issue.



The nose is a blood vessel-rich (vascular) part of the body that protrudes on the face in a vulnerable position. As a consequence, facial trauma can result in nasal injury and bleeding. The bleeding may be extensive or just a mild complication. When the nasal membranes dry out and crack, nosebleeds may occur spontaneously. This is usual in dry climates or during the winter months when the air is dry and warm from heaters in the home. If you take drugs that avoid normal blood clotting, you’re more likely to get a bloody nose (warfarin [Coumadin, Jantoven], clopidogrel [Plavix], aspirin, or any anti-inflammatory medication). Even a mild trauma may result in serious bleeding in this situation.

During the colder winter months, when upper respiratory infections are more prevalent and the temperature and humidity fluctuate more significantly, nosebleeds are more common. Furthermore, changing from a freezing cold outside climate to a warm, dry, heated home causes nasal drying and changes, making it more vulnerable to bleeding. Nosebleeds may also happen in hot, dry climates with low humidity, or when the seasons change.

Local (fracture due to a sharp blow, or nose-picking, for example) and general factors are the most common causes of epistaxis or nose bleeding. The nosebleed usually begins just inside the nostril’s entrance, on the middle, harder portion of the nasal septum. Since the blood vessels in this area are weak, they can easily burst and cause bleeding. People are more likely to get nosebleeds if they have the following risk factors:


  • Hereditary hemorrhage, for example, is a structural or anatomical
  • Nasal sprays and nasal steroids used for a long time (particularly prolonged or improper use of nasal steroids)
  • A sudden change in pressure causes barotrauma in the middle
  • Functional endoscopic sinus
  • For long periods of time, prolonged exposure to humid, dry
  • Allergic
  • Nasal septum that is deviated or
  • Cocaine
  • High blood pressure or an infectious disease (cold).
  • Connective tissue disease
  • Using aspirin, warfarin, isotretinoin, desmopressin, and other
  • Vascular
  • Deficiency in vitamins C and


Epistaxis carries the following risks:

  • Bleeding
  • A runny
  • Swelling and numbness are both
  • Face is
  • Anemia in rare
  • Deformity of the

Nosebleeds: First Aid

Sit back and lean over if you get a nosebleed. It is best to sit rather than lie down because holding the head above the level of the heart helps to prevent bleeding. It’s also necessary to bend forward. It allows blood to drain through the nose instead of down the throat.

Keep your fingers pinched together in the soft part of your nose until the bleeding ends. This could take anywhere from five to ten minutes. An ice pack put across the bridge of your nose can also be useful.

Preventative measures


Preventing nosebleeds can be as easy as taking the following precautions and measures:

  • Give up the habit of picking your
  • Blowing your nose softly is still a good
  • Smoking is not
  • In the winter, when the indoor air is dry, use a
  • To keep the inside of the nose moist, use a saline nasal
  • Wear a seatbelt or shoulder harness when driving, and use headgear while playing sports to avoid any facial

If the nosebleed continues or becomes chronic, consult your doctor, who may suggest using a heating instrument or a chemical swab to cauterize the blood vessel that is causing the problem, or applying a topical medication called thrombin to facilitate local blood clotting. To rule out bleeding disorders, blood tests can be requested. If the bleeding continues, the doctor can use nasal packs to compress the blood vessels and stop the bleeding.