Epistaxis, also known as nose bleeds, is a common presenting symptom for patients seeking ear nose and throat evaluation. It can occur in patients of all ages, but is frequently seen in children and the elderly. Although often times alarming, epistaxis is rarely life threatening. Most episodes are self limiting and resolve without need of medical intervention. However, when severe or recurrent seeking medical attention is often warranted.
The nasal lining is comprised of an extensive vascular network or superficial and deep blood vessels. Bleeding usually occurs in the front of nasal cavity along the nasal septum. Rarely bleeding may occur at other sites such as in the back of the nose near and or at junction of the throat, making treatment more difficult and complex.
Nose bleeds can be caused by a variety issues that include trauma, septal deviation, URI, sinusitis, tumors, or mucosal irritation such as allergic rhinitis. Additional causes also include systemic disorders such as hereditary hemorrhagic telangiectasia or problems with blood clotting seen in patients taking blood thinners or with congenital bleeding disorders.
Treatment for nose bleeds can often times be managed conservatively. Simple maneuvers for treating mild to moderate nose bleeds include applying firm digital pressure, use of a nasal decongestant, and remaining calm with relaxed breathing. For severe, persistent, or recurrent epistaxis please seek medical management. Treatment in these cases require consultation with a trained ENT physician.
Long term management and prevention requires use and adherence to nasal precautions such as: avoiding forceful nose blowing or nasal sneezing, avoidance of digital manipulation, use of saline nasal sprays, and avoidance of non prescribed blood thinning agents such as aspirin or other NSAIDs.