Frequent nosebleeds in women. Why does the nose bleed: causes of nosebleeds. Nosebleeds in children

Epistaxis, or bleeding from the nose can be a symptom of a number of diseases of the nose and other organs, and in addition, in some cases it is noted in healthy people.

The main causes of nosebleeds can be:
injury,
diseases of the nose and paranasal sinuses (sinusitis, rhinitis),
taking a number of medicines
blood diseases, etc.

With severe bleeding from the nose, which cannot be stopped on its own, urgently need to see a doctor, who will determine the cause of epistaxis, and determine the course of treatment.

Causes of epistaxis in adults

Bleeding from the nose is not always indicative of an existing disease and can sometimes occur in people without health problems. Bleeding from the nose, which occurs in a healthy person, is usually not profuse, depends on the previous emotional and physical stress and can be stopped without outside intervention.

Often, the cause of nosebleeds in a healthy person is the inhalation of frosty or dry air for a long time, which causes the nasal mucosa to dry out and rupture of small vessels. Usually in this case, nosebleeds are not profuse and stop without difficulty.

"Sunstroke" (overheating in the sun) can also cause nosebleeds in a healthy person. In this situation, epistaxis is accompanied by pain in the head, weakness, tinnitus, and even fainting.

When nosebleeds appear as a result of trauma to the nose (blow, fall), damage to the nasal structures (paranasal sinuses, cartilage, etc.) is likely. Usually, epistaxis resulting from an injury is accompanied by swelling and obvious pain in the nose and tissues that surround it. If the result of the injury was a fracture of the bones of the facial skull, usually becomes noticeable deformation of the nose or the entire face.

If, with mild bleeding from the nose, which looks like blood clots, mucous discharge from the nose appears, a possible cause is inflammation of the nasal mucosa, the so-called. rhinitis. Blood clots released during rhinitis appear as a result of injury to the small vessels of the nasal mucosa due to inflammation.

When epistaxis occurs against the background of pain in the head, runny nose and is accompanied by an increase in body temperature, the probable cause may be inflammation of the paranasal sinuses - sinusitis (frontal sinusitis, sinusitis, etc.).

When a nosebleed occurs in a patient with hypertension, the likely cause is a significant increase in blood pressure - hypertensive crisis. In this case, epistaxis occurs as a result of rupture of small vessels of the nasal mucosa due to increased pressure.

The appearance of nosebleeds may be associated with irritation of the nasal mucosa against the background of the use of a number of nasal sprays: Baconase, Nasonex and other drugs that contain corticosteroids or antiallergic (antihistamine) drugs. The formation of epistaxis is likely in people who have been taking drugs that prevent blood clotting for a long time: Warfarin, Heparin, Aspirin etc.

Frequent bleeding from the nose, especially when combined with uterine bleeding, a tendency to bruise, increased bleeding of the gums, is characteristic of blood diseases such as aplastic (when the bone marrow stops producing blood cells), leukemia (malignant blood disease), thrombocytopenic purpura (strong decrease in the number of platelets), etc.

Epistaxis is also one of the signs of nasal tumors (both malignant and benign). The main symptoms of nasal tumors are:
painful sore or swelling in the nose
bloody discharge from the nose (clear in appearance),
nose reshaping,
headaches, etc.

Causes of epistaxis in children

Nosebleeds in childhood also do not in all cases indicate an existing disease and may be associated with mechanical irritation (for example, fingers) of the nasal mucosa, nasal trauma, foreign bodies entering the nose (small particles of toys, peas, etc.). ).

If a child develops mucous discharge from the nose, in which blood clots are present, this usually indicates a runny nose (rhinitis).
Persistent, frequent nosebleeds in children, which are associated with a tendency to bruise, may indicate hemophilia or a number of other diseases that are associated with impaired blood clotting.

Causes of epistaxis in pregnant women

The main causes of nosebleeds in pregnant women are:
inhalation of frosty or dry air for a long time (in winter while walking),
lack of calcium or vitamin K in the body, which occurs during pregnancy and can cause epistaxis, as well as increased bleeding of the gums, etc.
nosebleeds, accompanied by severe pain in the head, may occur due to high blood pressure. In this case, medical assistance is required. Your blood pressure will be taken and the probable cause of bleeding will be determined.

First aid for nosebleeds in children and adults

In the event of nosebleeds, it is recommended to adhere to the following rules:
1. The patient should be seated and his head tilted forward. It is strictly forbidden to tilt the patient's head back in order to avoid swallowing blood and vomiting or the penetration of blood into the respiratory tract!
2. It is necessary to provide a patient with epistaxis with good access to fresh air (open the window, unbutton the patient's shirt collar).
3. Apply an ice pack to the person's nose. If the bleeding does not stop, use your finger to firmly press the nostril against the nasal septum for about 5-10 minutes. Due to compression of the vessels of the nasal mucosa, in most cases, bleeding stops.
4. If the cause of nosebleeds is an injury to the nose, and it is accompanied by a change and swelling of the contour of the nose or the entire face, put a handkerchief or an ice bag soaked in cold water on the nose area and consult a doctor urgently.
5. If the measures taken did not help stop the nosebleed, you can use some kind of vasoconstrictor medicine for the common cold (for example, Naphthyzinum, Nafazoline, Sanorin etc.). To do this, make a swab from a small piece of gauze or bandage, about 10-15 see This swab must be moistened with medicine and inserted into the nasal cavity.
6. When epistaxis is the result of a previous runny nose, it is necessary to lubricate a cotton swab with petroleum jelly and insert it into the nasal cavity. As a result of the action of Vaseline, the crust formed in the nose will soften, and the bleeding will stop.
7. When bleeding from the nose appears on the background of overheating, you should immediately take the patient to a well-ventilated place where the sun's rays do not penetrate. On the area of ​​the nose, it is necessary to apply a cloth soaked in cold water or ice.

In what situations should you urgently see a doctor?

In the following situations, you need to urgently consult a specialist:
with bleeding from the nose due to trauma, combined with deformation and swelling of the nasal contours;
with heavy bleeding from the nose, which appeared against the background of increased blood pressure or due to prolonged use of the medications listed above;
in case of bleeding from the nose, which appeared in a child due to the penetration of a foreign body into the nose, it is necessary to contact a specialist - ENT. It is forbidden to try to pull out a foreign body on your own!
Nosebleeds that don't stop anymore 30 minutes, and if the measures listed above do not bring results;
with frequent nosebleeds that do not stop for a long time, accompanied by a tendency to bruise and increased bleeding of the gums, etc.

Nosebleed Treatment

In a situation where the bleeding from the nose is persistent, medical care includes:
1. Nasal tamponade - a method to stop bleeding from the nose, involving the introduction into the nasal cavity of gauze, pre-treated with petroleum jelly or a special paste that promotes blood clotting. There are two methods of tampon insertion: anterior tamponade (insertion of the tampon from the side of the nostrils) and posterior tamponade (from the oropharynx).
2. Usage surgical methods stop bleeding from the nose is supposed in situations where other methods do not work, and involves blockage or ligation of the arteries supplying the nose with blood, and a number of other measures.

Minor, single nosebleeds do not imply special treatment. In case of frequent nosebleeds, it is necessary to contact a specialist who will conduct an examination, prescribe additional tests and determine the cause of nosebleeds.

With nosebleeds that have arisen against the background of sinusitis or rhinitis (runny nose), no special treatment is required. In such a situation, a sufficient measure would be treatment of the underlying disease.

When bleeding from the nose appeared on the background of taking drugs that inhibit blood clotting ( warfarin, heparin etc.), you should consult a doctor to adjust the dosage of drugs or prescribe a course of calcium and vitamins.

Everyone has experienced nosebleeds. According to the International Classification of Diseases, the phenomenon is called epistaxis and serves as a signal of the negative impact of various factors and pathologies. As a rule, it does not pose a danger to life. However, the causes that caused it can be very serious. If the situation is repeated regularly, is protracted, accompanied by a large loss of blood, then measures must be taken.

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To understand the cause of the condition, it is necessary to understand the mechanism of its development. Epistaxis is predominantly associated with capillary damage. In 9 out of 10 cases, it occurs precisely because of a violation of their integrity x, in the rest - because of a rupture of the artery.

Diseases that can cause epistaxis are quite diverse. Let's analyze the most common pathologies.

Table. Why does an adult regularly bleed from the nose

Cause	Description
Arterial hypertension	Sustained increase in pressure (BP) over 140/90 mm Hg. Can cause rupture of blood vessels in the nasal mucosa
Inflammatory process (acute/chronic)	Sinusitis, SARS, rhinitis can cause nosebleeds in an adult
Bad habits	Alcohol abuse, smoking and drug addiction can lead to regular bleeding. Alcohol dilates blood vessels, and drugs and cigarettes dry out the mucous membrane, leading to damage to blood vessels.
Diffuse connective tissue pathologies	An adult with lupus erythematosus, scleroderma, polymyositis often has a nosebleed
Hematological diseases	A set of pathologies that lead to a violation of the structure, number or activity of blood cells
Allergic reaction	One of the most common reasons. Occurs due to dust, pollen, food, etc.

Often, nosebleeds are due to traumatic influences, but other factors are also likely. Only one symptom is not enough to make an accurate diagnosis. A comprehensive examination is recommended.

Fortunately, bleeding itself rarely leads to serious consequences. It can be dangerous for people with bleeding disorders.

The fair sex is often faced with the fact that periodically blood flows from the nose while carrying a child. This phenomenon may be related to:

• increase in blood pressure;
• hormonal fluctuations.

From the 2nd semester, blood pressure increases due to an increase in the load on the mother's cardiovascular system. This is considered normal, but can cause damage to the nasal vessels. Hormonal fluctuations are also associated with changes caused by pregnancy. If bloody discharge flows from time to time, does not worsen the general condition and does not lead to large blood loss, then you should not worry.

It is important to know how to help yourself with sudden nosebleeds

Often teenagers complain that they constantly bleed from the nose. This may be due to a change in hormonal levels due to the onset of puberty. In girls, epistaxis sometimes coincides with the onset of critical days, which is also due to the release of hormones. In addition, teenagers experience significant emotional stress, which can cause nosebleeds. With frequent bleeding, it is worth visiting a doctor to exclude the presence of dangerous pathologies. Among them are congenital heart defects, hemophilia, diseases of the endocrine system, etc.

Epistaxis in a child is a real stress for their parents. The causes of nosebleeds in children are almost the same as those in adults. However, most often the situation is caused by factors such as:

• traumatic injury;
• dry air;
• vitamin deficiency;
• allergy;
• overheat.

The lack of B vitamins, vitamin K and ascorbic acid leads to the fact that the child is bleeding from the nose. Children often fall, hit, fight, which causes damage.

Babies quickly overheat in the sun. It is strictly forbidden to send a child for a walk in sunny weather without a hat.

Among children's cases of epistaxis, the presence of a foreign body is in the lead. If the child suddenly started bleeding, it is likely that he will place a small toy, pebble or other object in the cavity. In this case, you need to immediately seek medical help. Sometimes blood means that the child likes to "pick his nose." This unpleasant habit sometimes signals developmental disabilities.

Moderate picking is not considered abnormal

What does it mean if you went in a dream?

When bleeding at night, do not panic. If the blood from the nose went in a dream, then this may be due to fluctuations in blood pressure, preceding intense physical or emotional overload. If the blood from the nose during sleep went in large quantities, and the epistaxis itself did not last long, then the rupture of the aneurysm, a large vessel in the nasal cavity, or the rupture of neoplasms should be excluded. A nosebleed in a dream can also signal dry bedroom air.

Flows in the morning just like that

Most often, such a complaint occurs in the elderly. They periodically bleed from the nose due to dry mucous membranes. In addition, most older people have arterial hypertension. If the nose bleeds just like that in the morning, then the cause may be lack of sleep, fluctuations in atmospheric pressure, drinking alcohol before bedtime, etc. In rare cases, a symptom signals the occurrence of neoplasms, blood pathologies, and systemic diseases.

When blowing your nose

If during SARS the mucus from the nose comes out with a small amount of blood, then you should not worry. The appearance of brown fluid is associated with an inflammatory process localized on the mucosa. However, if a person feels healthy, but finds blood when blowing his nose, then it is necessary to undergo an examination. A similar phenomenon is considered a symptom of cysts in the sinuses, polyps, chronic sinusitis, etc.

If it happens often

In most cases, a person can answer the question why the nose bleeds on their own. For some, this was the result of a stroke, someone found high blood pressure, and someone is struggling with SARS. However, it happens that a person cannot understand why he can bleed from his nose and why this is repeated regularly. Sometimes the condition provokes pharmacological therapy. Among the possible causes are also heart failure, anatomical deformities, neoplasms, etc.

Regular nosebleeds - a reason to see a doctor

Persistent nosebleed

Regular epistaxis is an alarming signal. When the nose bleeds every day for no apparent reason, hematological diseases are suspected. The symptom is typical for:

• anemia;
• neoplastic diseases;
• Werlhof's disease, etc.

Anemia is a reduction in hemoglobin levels and a decrease in the number of red blood cells. Neoplastic pathologies is the collective name for a whole group of diagnoses that affect the hematopoietic and lymphatic systems. Werlhof's disease is a hemorrhagic diathesis. Pathology affects platelets.

From what comes every day periodically?

Such frequent epistaxis is a sign of tumor formations. One of the reasons why the nose bleeds daily is nasopharyngeal cancer. Pathology is typical for East Asian territories, but also occurs in Russia. It not only causes nosebleeds in the morning or at any other time of the day, but also leads to congestion, pain, tinnitus, etc.

What if it gives you a headache?

Symptoms may be associated with a pressure surge. If nosebleeds have opened and your head hurts, then the following are likely:

• hypertensive crisis ();
• chronic sinusitis or sinusitis;
• allergic reaction, etc.

Severe dizziness, pain, the presence of foam in the bloody discharge are characteristic of lung damage. An increase in temperature signals the penetration of an infection or the course of an inflammatory process. If prolonged excruciating headaches and bleeding from the nose for a long time, then this is an occasion to be checked for neoplasms.

If there is blood from the nose, then it is important to stop it not only quickly, but also correctly. It is forbidden to take a horizontal position or raise your head up. If bleeding has flowed, then:

• it is necessary to take a half-sitting position;
• loosen tight clothing;
• apply a cold compress to the bridge of the nose (no more than 10-12 minutes).

If the bleeding from the nose does not stop, then you should call an ambulance. The same should be done with a large blood loss.

Regardless of the cases in which the child has a nosebleed, you should use the scheme above. If necessary, turundas moistened with saline can be injected into the nose. One-time use of vasoconstrictor drops is allowed.

Useful video

Otolaryngologist Igor Branovan will talk about the causes of frequent nosebleeds and explain what to do if your nose bleeds:

Conclusion

1. There are many reasons why a nose bleeds.
2. The most common are allergies, the course of the inflammatory process and mechanical damage.
3. There are also more serious pathologies: vascular and heart diseases, hematological diseases, neoplasms, etc.
4. Only a doctor can determine what to do if the blood comes from the nose, and what the appearance of a symptom means in a particular case.
5. To fully establish the diagnosis, it is necessary to obtain data on the patient's condition in full.

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Sudden nosebleeds can occur for a variety of reasons. In most cases, it is not an alarming symptom, but occurs as a result of the body's reaction to certain factors. If bleeding becomes regular, then it is necessary to pay attention to its frequency and time of occurrence (for example, in the morning, at night, during the daytime, etc.).

The consistency of the blood is also of particular importance (thick, thin scarlet or blood with clots). Some serious diseases are accompanied by nosebleeds, which are their first warning signs.

There are many factors that can cause nosebleeds. The rarest but most serious cause of this condition is pheochromocytoma. The disease is a tumor of the adrenal glands.

The disease is accompanied by an increase in the production of stress hormones, blood pressure and the occurrence of dryness in the nasal cavities. A tumor can be detected only with the help of an examination, and nosebleeds are considered the most common symptoms of the development of a neoplasm in the adrenal glands.

The causes of nosebleeds can be the following factors:

Regular nosebleeds appear in patients with abnormalities in the hematopoietic system and vascular diseases. Allocations of blood at the same time can be scarce or plentiful. The patient may not know about some diseases of this type for a long time. A timely visit to the doctor and a comprehensive examination will help to establish the diagnosis.

Symptoms and Diagnosis

Nosebleeds can be accompanied not only by the release of blood from the nose, but also by a number of additional symptoms. In medical practice, this condition is divided into two categories. Bleeding can occur from the front or back of the nose. In the first case, the main symptom is the discharge of blood from one or two nostrils at the same time. In the second, additional symptoms are always present.

Additional symptoms of nosebleeds:

• nausea and vomiting (vomit may contain blood impurities);
• "noise in ears";
• decrease in the amount of urine (or its complete absence);
• hemorrhagic shock;
• dizziness;
• dyspnea;
• pallor of the skin;
• blurred vision ("flickering flies in the eyes");
• tachycardia;
• thirst;
• lowering blood pressure;
• general weakness of the body;
• disturbance of consciousness.

If regular bleeding from the nose occurs, it is necessary to be examined by an ENT doctor and a general practitioner. These specialists may prescribe an additional consultation with specialized physicians. In most cases, the diagnosis of bleeding is not difficult, but if necessary, the patient will need to do an ultrasound or ECG of the heart and pass general blood and urine tests. Based on such examinations, an accurate diagnosis will be established and a clinical picture of the state of health will be drawn up.

Additionally, the following procedures can be assigned:

• nasal endoscopy (with the help of special equipment, the nasopharynx and posterior parts of the nose are examined);
• coagulogram (a special study of blood clotting);
• rhinoscopy (the nasal cavity is first cleared of all contaminants and blood clots, and then examined to identify the source of bleeding);
• pharyngoscopy (a comprehensive examination of the oropharynx).

How to stop bleeding?

Stopping nosebleeds is not a problem in most cases. During an attack, you must take a sitting position and tilt your head forward. You can squeeze the wings of your nose with your fingers or put an ice cube on the bridge of your nose. A regular towel soaked in cold water will also help stop bleeding. If a similar symptom occurs regularly, then not only special treatment is necessary, but also a mandatory clarification of its exact causes.

How to treat with medicines?

Treatment of nosebleeds with medicines is carried out with first aid to the patient or in the presence of diseases of which it has become a symptom. The list of drugs is selected by the doctor based on the overall clinical picture of the patient's health. For example, if vascular diseases are the cause of blood from the nose, then the course of treatment will include drugs to improve blood quality and eliminate existing diseases.

For nosebleeds, you can use:

• vasoconstrictor drops used to treat the common cold (Sanorin, Naphthyzin);
• Aminocaproic acid (the drug is administered intravenously, the procedure is prescribed by a specialist);
• calcium chloride (during nosebleeds, you need to take 1-2 teaspoons of a 10% solution);
• Vikasol (the drug is administered intramuscularly, it is not intended for long-term use);
• Dicyon (a drug for the normalization of blood clotting, may be prescribed by the course);
• a swab with hydrogen peroxide (a cotton swab should be moistened with the preparation and inserted into the nasal passage).

Folk remedies

Some folk remedies for stopping nosebleeds may seem specific, but their effectiveness has been proven not only by many years of practice, but also by medical research. During an attack, for example, it is recommended to hang an iron key on a woolen thread around the neck (the key should be placed on the back). Thanks to this technique, the blood stops almost instantly.

Examples of folk remedies to stop nosebleeds:

• salt water (in half a glass of water at room temperature, dilute a teaspoon of salt, take two tablespoons of the resulting solution);
• aloe leaves (it is recommended to use aloe leaves not only during attacks of nosebleeds, but also for their prevention);
• swab with fresh nettle juice (leaves of fresh nettle should be washed, crushed and squeezed out the juice, moisten a cotton swab in the resulting liquid and insert it into the sinuses);
• alcohol lotion (a cotton pad should be moistened with alcohol and applied to the bridge of the nose);
• washing the nose with alum powder (the product is sold in pharmacies, one teaspoon of the powder must be dissolved in water at room temperature and rinsed with nasal passages).

Herbal treatment

With frequent nosebleeds or for their prevention, it is recommended to use herbal medicine. Herbs that can strengthen blood vessels include knotweed, stinging nettle, yarrow, horsetail and shepherd's purse. Dry mixes can be purchased at a pharmacy or prepared independently.

From each herb, you can make separate decoctions or make a medicinal collection from them. The ingredients are first mixed in the indicated proportions, and then a teaspoon of the workpiece is poured into a glass of boiling water. The infusion can be used to wet swabs for nosebleeds or taken orally in half a glass three times a day.

Collection example:

• dioecious (4 tsp);
• (1 tsp);
• (1 tsp);
• (3 tsp).

Patients with regular nosebleeds need to change their diet and replenish the supply of vitamins in the body. Eat more foods containing potassium and ascorbic acid. You can take vitamins C and K, which are sold in pharmacies in various forms. Regular replenishment of the supply of nutrients in the body will not only relieve bleeding, but also create a full-fledged prevention.

With regular nosebleeds, aspirin-containing foods should be excluded from the diet:

• cherry;
• Strawberry;
• raspberry;
• grape;
• blackberry.

In most cases, when a nosebleed occurs, the patient reflexively throws his head back. Under no circumstances should this be done. With a strong release of blood, such actions can cause it to be swallowed or enter the respiratory tract. The most serious negative consequence will be blockage of the bronchi and the appearance of vomiting. Head with nosebleeds must be tilted forward.

Preventive measures

The main means of preventing nosebleeds is the timely treatment of all diseases and timely access to specialists in the event of alarming symptoms. Some processes in the body are recommended to be regularly monitored by special tests and examinations.

Measures to prevent nosebleeds are the following actions:

• control of blood clotting and blood pressure;
• exclusion of head, face and nose injuries;
• regular air humidification;
• strengthening of blood vessels with special preparations (for example, Askorutin);
• minimal contact with possible irritants (inhalation of harmful substances);
• complete treatment of allergic reactions.

Epistaxis, or nosebleeds, is a fairly common phenomenon that occurs in both adults and children due to various diseases or other causes. Visually, this manifests itself in the form of varying degrees of intensity of blood flow from the nostrils.

Nosebleeds are divided into anterior and posterior. The division is based on the physiological characteristics of the blood supply to the nose.

What are nosebleeds

In most cases, the source of bleeding is the Kisselbach's plexus. Such bleeding is not dangerous, it stops on its own after 3-5-7 minutes.

The source of the most common anterior bleeding (in 90-95% of cases) is the Kisselbach plexus - a dense submucosal cavernous venous network with a mass of small capillaries and arterioles that supplies blood to the anterior nasal cartilage. Epistaxis from this area, as a rule, does not pose a danger due to the small volume of blood loss. Blood flows either in a thin stream or drops. With normal clotting, bleeding stops on its own within a few minutes.

In 5-10% of cases of posterior bleeding, blood flows from the branches of large arteries in the posterior or middle sections of the nose. Bleeding from these arteries is profuse, can have serious health consequences and even, in rare cases, lead to the death of the patient. Blood of a bright scarlet color flows out in a continuous stream. This bleeding does not stop on its own. Another manifestation of posterior epistaxis is the appearance of blood in the mouth and bloody vomiting arising from the ingestion of blood flowing from the nose through the pharynx into the oral cavity.

In some severe cases, bleeding from the orbit or lacrimal opening may be observed, while the blood rises from the nose up the nasolacrimal canal.

Depending on the volume of leaked blood, several degrees of blood loss are distinguished:

• Minor blood loss, in which from a few drops to several milliliters of blood is lost. Such bleeding is not dangerous to health and does not lead to any consequences. The only negative point may be fright, hysteria or fainting in young children.
• A mild degree of blood loss, the volume of blood in which does not exceed 700 ml in an adult, is not more than 12% of the total amount of circulating blood. Such blood loss causes slight weakness, dizziness, rapid pulse and flies before the eyes. Possible blanching of visible mucous membranes and skin.
• The average degree is characterized by blood loss from 1000 to 1400 ml in an adult, which is up to 20% of the total circulating blood volume. It is accompanied by more pronounced symptoms in comparison with a mild degree: weakness, dizziness, headache, thirst, shortness of breath.
• Severe degree with massive bleeding. The volume of blood loss exceeds 20% of all circulating blood in the body. Massive blood loss leads to hemorrhagic shock, which is expressed in a sharp drop in blood pressure, lethargy, various disturbances of consciousness up to its loss, insufficient blood circulation in the internal organs. A great danger is sudden short-term, but massive bleeding, leading to large blood loss.

Causes of nosebleeds

Why is the nose bleeding? Let's consider the reasons. The factors that cause nosebleeds are divided into local (local) and general (systemic).

Local factors:

• Various .
• Mechanical damage to internal structures, which include the mucous membrane. Violation of its integrity can occur when inaccurate removal of dried crusts, from intense scratching in the nose with a finger, rough repeated blowing your nose, etc. Young children are very fond of putting various foreign objects into their mouths and noses, thereby causing injury to the mucosa.
• Barotrauma with a sharp drop in barometric pressure, characteristic of divers, pilots, climbers.
• Congestion of the mucous membrane, its thinning or exposure to various drugs in inflammatory processes in the nose, for example, with influenza, or chronic sinusitis. Particular risk when used for the treatment of nasal steroid spray.
• Inhalation through the nose of narcotic drugs, mainly cocaine.
• Anatomical deformities of the nose. As an example, or telangiectasia caused by Rendu-Osler disease.
• and . Oncological include nasopharyngeal carcinoma, benign - angiomas or.
• Prolonged inhalation of cold winter air. In this case, the low relative humidity of the air itself plays a role.
• Heat stroke or sunstroke from being in the hot sun in hot weather.
• Epistaxis as a consequence of surgical intervention in the nose area.
• Possible drainage of the mucosa when using an oxygen catheter.

Systemic factors for nasal bleeding:

• Arterial hypertension.
• Vascular diseases.
• Congenital vascular pathology.
• Blood diseases (leukemia, hemoblastosis, anemia, etc.).
• Avitaminosis, mainly lack of vitamin C and K.
• The use of alcoholic beverages that contribute to the expansion of blood vessels, including in the nose.
• Heart disease accompanied by heart failure.
• Connective tissue diseases.
• Side effects from taking NSAIDs (non-steroidal anti-inflammatory drugs).
• Bleeding disorders such as hemophilia.
• Hemorrhagic diathesis.
• Severe kidney disease.
• Physical stress.
• Severe infectious diseases, including HIV infection, AIDS.
• Hormonal changes in the body.

First aid for nosebleeds

When nosebleeds should not tilt your head back! On the contrary, it is necessary to slightly tilt the head and torso forward and press the wings of the nose to the bridge of the nose with your fingers. It is desirable to put cold on the bridge of the nose.

A person who has a nosebleed can be helped before going to the doctor. To do this, you need to perform a series of manipulations in turn:

1. First of all, plant a person and slightly lower his head to ensure a good outflow of blood. If it is difficult for the patient to sit on his own, it is better to lay him down, but raise the head end of the couch and turn his head to one side. A common folk measure, like throwing back the head, strictly prohibited. This will not stop the blood, but can only lead to undesirable consequences in the form of its penetration into the mouth, ingestion into the stomach, and in severe cases, into the respiratory tract.
2. Provide an influx of fresh air (unbutton the shirt, open the window).
3. Place an ice pack on the bridge of your nose. If the bleeding does not stop after a short time, then you need to press the nostril, from which more blood flows, to the nasal septum for 5 or 10 minutes. Blowing your nose is prohibited. If blood enters the mouth, it should be spit out.
4. If the above measures did not work, you can try to make a turunda or a swab from sterile cotton wool, moisten it with 3% hydrogen peroxide or, for example, Sanorin, Naphthyzin, Galazolin, Tizin. Enter this turunda into the nasal passage and leave until the bleeding stops.
5. When epistaxis appears and crusts formed after it, it is advisable to lubricate the swab with petroleum jelly. Softening parched mucosa will help stop bleeding.
6. If the nosebleed is caused by sunstroke, then the person should be moved to a cool, well-ventilated place and put a cool cloth on the forehead and face, and ice on the bridge of the nose.

In case of massive bleeding resulting from a nose injury with a distortion of its anatomical structure, or in the case when it is not possible to stop the bleeding on your own, you should immediately consult a doctor, and temporarily put cold on the bridge of the nose to relieve swelling.

Nosebleed Treatment

After examining, determining the degree and cause of bleeding, the doctor chooses a way to stop it and, if necessary, further treatment.

Specialized medical care consists of the following measures:

• Nasal tamponade is a way to stop nosebleeds by introducing into its cavity tampons impregnated with one of their hemostatic agents, for example, thromboplastin. A hemostatic sponge, which includes thromboplastin and thrombin, helps well.

Depending on the situation, the doctor makes an anterior tamponade - from the side of the nostrils, or a posterior one - from the pharynx.

• Cauterization of bleeding vessels. There are many ways. The means of cauterization are some acids - lactic, trichloroacetic or chromic. Zinc salts, alum, tannin, silver nitrate solution are also used.
• Highly effective modern methods of stopping nosebleeds are ultrasonic disintegration (intentional destruction of the existing blood supply to hypertrophied nasal conchas using an ultrasonic waveguide), laser therapy (laser coagulation), exposure to liquid nitrogen (cauterization by cold), electrocoagulation (cauterization by electricity).
• With frequent bleeding, accompanied by a significant loss of blood, a surgical operation is indicated, which consists in ligation of large vessels and arteries, as well as in detachment of the periosteum at the site of bleeding, leading to desolation of the vessels.

It is important to know that nosebleeds are not always harmless. It is often a symptom of a serious illness. If it is strong and does not stop for a long time, and even more often it repeats, leading to a deterioration in the condition, then it is imperative to consult a doctor for a detailed examination in order to determine the causes of epistaxis and choose a method of qualified treatment.

Video version of the article:

The program "About the most important thing" tells about the causes of nosebleeds:

Epistaxis is bleeding from the nasal cavity, which is manifested by the outflow of blood from one or both nostrils. In medical terminology, this phenomenon is interpreted as epistaxis.

Bleeding from the nose is quite common, both in adults and in children, and is the result of some disease or other reasons.

The mucous membrane of the nasal cavity is rich in blood vessels, damage to which leads to the development of epistaxis. Injuries can be both spontaneous and caused by various injuries. In most cases, nosebleeds begin during sleep.

Types of nosebleeds

Depending on the physiological characteristics of the blood supply to the nose, anterior and posterior nosebleeds are distinguished.

The source of the most common (90-95%) epistaxis is the Kisselbach plexus, which is the anterior-inferior section of the nasal septum, consisting of a dense submucosal cavernous venous network with a huge number of arterioles and small capillaries, which supplies blood to the anterior nasal cartilage. In most cases, anterior bleeding from the nose does not pose a particular danger to human health, since the volume of blood loss is insignificant. The blood flowing from the nose looks like drops or a thin jet. If blood clotting is normal, then within a few minutes the bleeding stops on its own.

Sometimes (5-10%) blood flows from the large arteries of the middle or posterior parts of the nose. In such cases, we speak of a posterior type of nosebleed. The outflow of blood from these arteries is quite plentiful. A continuous stream of blood has a bright scarlet color and does not stop on its own, which can lead to serious health consequences, and in some cases even cause death. Sometimes a manifestation of posterior epistaxis can be the appearance of blood in the mouth and hematemesis, which occurs as a result of swallowing blood flowing through the nasopharynx from the nose into the oral cavity.

In especially severe cases, blood can rise from the nose along the nasolacrimal canal upward, provoking bleeding from the eye socket or lacrimal opening.

The volume of blood flowing from the nose allows you to determine the degree of blood loss.

• A slight degree of blood loss, which is characterized by a slight loss of blood (from a few drops to a few milliliters), which does not pose a health hazard.
• A mild degree of blood loss, in which the volume of leaked blood in an adult does not exceed 700 ml. At the same time, a person experiences dizziness, slight weakness, flies before the eyes, and a rapid pulse.
• The average degree of blood loss is characterized by blood loss in an adult from 1000 to 1400 ml. This condition is accompanied by tinnitus, weakness, headache, dizziness, shortness of breath, thirst.
• Severe blood loss is manifested by massive nosebleeds with blood loss exceeding 20% ​​of the total blood circulating in the body. Massive blood loss leads to hemorrhagic shock, which is expressed in insufficient blood circulation in the internal organs, a sharp drop in arterial fall, impaired consciousness and its loss, lethargy.

Why does the nose bleed

Causes of blood from the nose can be local and general.

Causes of nosebleeds in adults

The most common causes of nosebleeds in adults include:

• various injuries of the nose;
• foreign bodies that have entered the nose, as well as injury to the internal cavity of the nose with a finger;
• inflammatory diseases (ARVI, allergic rhinitis, chronic sinusitis, etc.).

Among other possible causes of nosebleeds in adults of a local nature, there are:

• a sharp drop in barometric pressure, as a result of which barotrauma occurs, which occurs most often in climbers, pilots, and divers;
• prolonged inhalation of frosty air at its low relative humidity;
• inhalation through the nose of cocaine or some other drugs;
• sun or heat stroke;
• anatomical deformities of the nose (telangiectasia or deviated septum);
• surgical intervention in the nose;
• benign and malignant tumors of the nose;
• drying of the nasal mucosa, as a result of the use of an oxygen catheter.

The most common systemic causes of nosebleeds in adults include:

• arterial hypertension;
• allergy;
• colds.

Other possible causes of nosebleeds in adults include:

• heart failure;
• blood diseases (ITP, hemoblastosis, anemia, etc.);
• vascular diseases;
• alcohol consumption;
• deficiency in the body of vitamin K or C;
• side effects from the use of drugs;
• systemic connective tissue diseases.

Causes of nosebleeds in children

Nosebleeds in children occur most often from the anterior nasal septum. The immediate cause of this phenomenon is considered to be a violation of the integrity of the vessels.

Common causes of nosebleeds in children include:

• beriberi, including vitamin C deficiency;
• increased blood pressure;
• hypertension in adolescents during puberty;
• pathology of the blood coagulation system;
• congenital heart defects;
• chronic diseases of the liver and kidneys;
• overheating, including hyperthermia in infectious diseases.

Local causes of nosebleeds in children include:

• any trauma to the nose (including picking the nose), getting into the nasal cavity of a foreign body;
• curvature of the nasal septum;
• chronic and anterior dry rhinitis;
• benign and malignant neoplasms of the paranasal sinuses and nasal cavity.

How to stop a nosebleed

When a nosebleed opens, it is necessary to take a number of first aid measures.

• The patient's head should be much higher than the body.
• To prevent blood from entering the nasopharynx and mouth, the patient's head must be tilted forward.
• With nosebleeds, it is strictly forbidden to blow your nose.
• When bleeding from the nose, first of all, it is necessary to apply ice or another source of cold to the bridge of the nose.
• With anterior bleeding from the nose, you need to pinch your nose for 5-7 minutes.
• If the previous procedure did not help stop the bleeding, it is necessary to put cotton swabs soaked in hydrogen peroxide into the nasal passages and press them against the nasal septum with your fingers for half an hour. The length of the tampon is 2.5 cm, the thickness is 1.5 cm, and for children it is 0.5 cm.

If it was not possible to stop nosebleeds on your own, then if you have the following factors, you should consult a doctor:

• Nosebleed does not stop within 10-20 minutes or nose bleeds every day
• there is blood from the nose with an increase in blood pressure, diabetes, a violation of blood clotting;
• with the constant use of drugs (Ibuprofen, Heparin, Aspirin);
• often bleeding from the nose;
• fainting or fainting due to nosebleeds;
• blood entering the throat, which causes hematemesis.

Ways to stop nosebleeds

• Attach a slice of a raw onion to the back of the neck and press firmly.
• Bury in the nose drops of freshly squeezed yarrow juice.
• Dousing with cold water for severe nosebleeds.
• Periodic retraction through the nose of salty or slightly acidified (for 1 tablespoon of water - 1 tsp of vinegar) water.
• If blood comes from the left nostril, it is necessary to raise the left hand above the head, and hold the nostril with the right. When bleeding from the right nostril, do everything symmetrically.