Problem of the week – Nosebleeds

Nosebleeds(aka Epistaxis) were by far the most common problem of the week once again.  This is not surprising as winter time when the heat is on and the air is dry is what creates a setting where nosebleeds can occur.

Why do we get nosebleeds? –  The nose has a very rich blood supply throughout and when the nasal membranes get dry, this can lead to crusting and small tears in the membrane which extends to the blood vessels which in turn tear as well and start bleeding.  When the nose bleeds, it bleeds into any open area so it is less likely to stop.

Nosebleeds can be broken up into anterior and posterior nosebleeds.

Anterior Nosebleeds – these occur in the front part of the nose and typically come out the front.  However if you lie down or place your head back then they will go down your throat.

Posterior Nosebleeds – these are more severe and go down the back of the throat even when you’re sitting up.

What should I do to stop the nose bleeds:

Anterior nosebleeds can usually be stopped by sitting up and squeezing closed the soft part of the nose.  This applied pressure to the blood vessel in the front that is bleeding.

Posterior nosebleeds are difficult to control and if blood continues to go down your throat then you should contract your doctor or go the the emergency room for management.

How can I prevent nosebleeds – The key is keeping your nose moist.  A gel such as Ayr nasal gel can be pushed into the nose gently and pinched up.  Do not pick out crusts?(almost everyone does at some point)  Use a humidifier in the bedroom at nighttime.

What if I am on blood thinners – Blood thinners such as coumadin and other comparable agents make nosebleeds much worse.  If you are blood thinners then you should check with your physician on how best to manage your nose bleeds.  Many people don’t realize the low dose Aspirin is a blood thinner and in fact contributes to significant nosebleed problems.  Again check with your physician before doing any alterations in your blood thinner medicine.

This is only a somewhat brief synopsis of nosebleeds.  As always, we welcome your calls with questions on how to manage your nosebleed problem.

Dr Bert Brown

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