Epistaxis

Bleeding from inside the nose is a common complaint presenting an emergency. Epistaxis is often a frightening sight to the patient and the attendants, especially if the patient is a kid. There are a variety of causes which can lead to bleeding from the nose.

Local causes

• Finger nail trauma due to excessive nose picking. This is the most common cause among the children.
• Trauma to nose due to road traffic accident or being hit on the nose by a ball or fist.
• Fracture of the nasal bones.

Infections

• Viral rhinitis (infection of the nose).
• Acute sinusitis

Others

• Foreign bodies in nose
• Deviation of the nasal septum
• Atmospheric changes such as sudden movement to high altitudes.
• Any growth in the nasal cavity, like polyps, benign or malignant tumors.

General Causes

• Hypertension – commonly seen in old age
• Heart diseases
• Pregnancy
• Bleeding disorders – when the patient has a deficiency in the system responsible for control of bleeding there is an abnormal tendency to bleed.
• Drugs- like excessive use of analgesics for pain.
• Acute general infections like typhoid, pneumonia, malaria, dengue fever, measles etc.
• Idiopathic - at times the cause of bleeding may not be clear.

Management
- Don’t panic because most of the time bleeding can be controlled by pinching the nose tightly for about five minutes.

- Ice compress can be applied in the nose. They cause bleeding blood vessels to constrict & bleeding stops.

- If bleeding is profuse the patient should be taken to the doctor. It may require inserting packs in the nose to stop the bleeding.

- Hypertensive patients should take their blood pressure controlling medication regularly.

- Excessive nose picking is a very common cause of bleeding both in children & young adults and should be discouraged.