Dear Readers,
C. Riley from Harbour View, Kingston, is worried about frequent nose bleeds that her five-year-old son is experiencing. She asks Lifeline "Is it OK to have nose bleeds or is it serious?" and "What is the best action to take during a nose bleed?"
Most nose bleeds are not extensive and are not serious in nature. However, if bleeding is prolonged and heavy or very frequent then a doctor should be consulted. There are some bleeding disorders and blood diseases which can present with epistaxis (nose bleed) and would require urgent attention. Some conditions which can cause nose bleed are:
Haemophilia
Leukaemia
Aplastic anaemia
Hodgkins disease
Rheumatic fever
Thrombocytopenia
Liver disease
The use of anticoagulants (blood thinners) and aspirin can also result in nose bleeds. In some people the prolonged use of nose drops can also result in a nose bleed. Most nose bleeds occur because of rupture of one or a few of the tiny blood vessels (capillaries) which run quite superficially in the tissues lining the nose. These vessels can bleed due to several causes.
Most obviously, a blow to the nose can result in a nose bleed. But children, unknown to their adult care givers, do things like push foreign objects, including peas and buttons or other small items up into the nostrils. Bleeding can then result from the trauma of pushing the object up into the nasal cavity or from the subsequent resulting inflammation. This can cause recurring nose bleeds in a child who had no previous significant history of nose bleeds. In people with allergies, both the itching of the nose and the sneezing can result in nose bleeds. The common cold or even dryness to the nasal mucous (tissues lining the insides of the nose) can result in nose bleeds.
Nose bleeds most often are not painful but can be frightening if bleeding seems to continue for a prolonged time. Usually, however, not much blood is actually lost.
When a nose bleed occurs the affected person should:
Sit over a basin.
Apply constant pressure to the nasal bridge and nostrils by pinching this area.
Bend the head forward (not backward).
Spit out all blood fell in the throat into the basin.
If bleeding still persists after pressure has been applied for 10 minutes, then an ice pick should be applied to the nasal bridge for another 10 minutes. Do not blow the nose after this. When the nose bleed is serious, a physician's attention is warranted. The doctor may pack the nose with gauze and leave the gauze in place for several hours.
Occasionally, an ear, nose and throat (ENT) surgeon has to be consulted for nose bleeds when they occur so frequently that surgery is contemplated. The broken blood vessels in the nose can be cauterised or even more rarely a large blood vessel which supplies the nasal vessels may be tied off.
Healthy life habits and a clean environment can help.
- Avoid dust, smog and conditions which trigger nasal allergies.
Don't pick the nose
Avoid viral upper respiratory tract infections. Practise proper hygiene and susceptible individuals should obtain yearly flu shots.
Eat plenty green, leafy vegetables which are good sources of vitamin K which is needed for blood clotting.
Take vitamin C supplements which help to prevent blood vessels' fragility.
Take low-dose vitamin K to help the blood clot better.
Do not smoke
Do not place any foreign objects in the nose.
Note: A little white vinegar soaked into a bit of cotton and put inside the nasal cavity for 10 minutes may also stop a nasal bleed, as the vinegar tends to cauterise the bleeding vessels inside the nose.
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