Nose Bleeding or Epistaxis

What is Epistaxis / Nose Bleeding:-

Epistaxis is a medical term for nose bleeding.

The nose is a part of the body that is very rich in blood vessels (vascular) and is situated in a vulnerable position on the face. Nosebleeds can occur spontaneously when the nasal membranes dry out, crust, and crack.

It has been estimated that up to 60% of the population has had at least 1 episode of epistaxis throughout their lifetime. Approximately 5-10% of the population experiences an episode of active nasal bleeding each year. Fortunately, fewer than 10% of these patients visit a physician for this problem and only one of those ten will require hospitalization. The incidence increases with advancing age, during the winter months, and epistaxis is more common in males. Usually, in pregnancy, the bleeding of epistaxis is in small quantity and self limiting, but at times it can be severe & life threatening. That is why it should never be treated as a harmless event either from the diagnostic or therapeutic point of view.

In homoeopathic constitutional medicines not only cures but attacks the root cause of the problem resulting in complete cure and will save you from relapses.

Homoeopathic treatment prescribed after a complete case taking firstly act on the affected area of the nose resulting in the stoppage of bleeding, removes swelling, reduces the pain, heals the injured tissues and then acts on the underlying cause of epistaxis like infections, bleeding disorders, and so on. The need of the other medicines patient is on like aspirin, medicine for blood pressure and so on also reduces slowly as medicines act holistically addressing all the complaints of the patient.

In homoeopathy there are special anti hemorrhagic medicines and constitutional medicines which are competent enough to remove problems from roots.

In short the treatment is targeted towards the root cause of the illness and hence the disease is treated from the core. Homoeopathy believes in treating the patient and not just the disease.

Types

There are two types:

Anterior epistaxis(90% cases,originates from the Kiesselbach plexus or Little’s area.)

Posterior epistaxis(Originates from the posterior nasal cavity)

Causes:-

LOCAL FACTORS

Most common factors

  • Trauma, usually a sharp blow to the face results in epistaxis. This may be associated with nasal fracture.
  • Foreign bodies, such as fingers during nose-picking.
  • Inflammatory reactions like acute respiratory tract infections, chronic sinusitis, allergic rhinitis or environmental irritants

Other factors

  • Anatomical deformities like septal spurs or hereditary hemorrhagic telangiectasia.
  • Insufflated drugs particularly cocaine.
  • Intranasal tumors like nasopharyngeal carcinoma or nasopharyngeal angiofibroma.
  • Low relative humidity of inhaled air particularly during cold winter seasons.
  • Nasal cannula O2 tending to dry the olfactory mucosa.
  • Nasal sprays particularly prolonged or improper use of nasal steroids.
  • Surgery, septoplasty and functional endoscopic sinus surgery.

SYSTEMIC FACTORS

Most common factors

  • Allergies.
  • Infectious diseases (like common cold).
  • Hypertension also allergic to aspirin.
  • Other factors
  • Drugs — Aspirin, Fexofenadine / Allegra /Telfast, warfarin, ibuprofen, clopidogrel, isotretinoin, desmopressin, ginseng and others.
  • Alcohol (due to vasodilation).
  • Anemia.
  • Connective tissue disease.
  • Bleeding disorders.
  • Envenomation by mambas, taipans, kraits, and death adders.
  • Heart failure (due to an increase in venous pressure).
  • Hematological malignancy.
  • Idiopathic thrombocytopenic purpura.
  • Pregnancy (rare).
  • Vascular disorders.
  • Vitamin C or Vitamin K deficiency.
  • von Willebrand’s disease.
  • The consumption of hot foods and drinks like sugar, salt, nuts, coke (googka) and so on.

Complications

  • Epistaxis is relatively benign in nature, but it can produce a serious, life-threatening situation. Complications include:
  • Nausea and vomiting due to the swallowing of blood.
  • More serious complications can include anemia, hypovolemic shock, airway obstruction and very rarely, death.
  • The underlying disorder, disease or conditions can also cause complications.

Symptoms & Signs:-

  • Bleeding which is seen usually from one nostril in anterior nosebleed however posterior nosebleed causes bleeding down the back of the mouth and throat. When the patient leans forward, the blood may flow from the nostril.
  • Nose pain.
  • Nose swelling.
  • Signs of excessive blood loss include
  • dizziness,
  • weakness,
  • confusion, and
  • Fainting.

Risk Factors

A risk factor is something that increases your chance of getting a disease or condition. Risk factors for nosebleed or epistaxis include :

  • Irregularity in the structure of the nose
  • Abnormalities of the blood vessels in the nose (angiomas)
  • Dry climate
  • Winter, with dry, heated indoor air
  • Allergies
  • Colds
  • Sinusitis
  • Infections like
  • Chickenpox
  • Malaria
  • Influenza
  • Scarlet fever
  • Typhoid fever
  • High blood pressure

Diagnosis:-

The doctor takes a detail of your symptoms and medical history, and performs a physical examination. Your pulse and blood pressure will be taken carefully, because severe bleeding can cause these to become dangerously low.

Tests may include :-

Sinus x-rays, to identify abnormalities or a mass in the nasal region

Endoscopy, using a thin, lighted tube to examine nasal tissues not visible from the front of the nose

Blood tests, to check for anemia, low blood platelets, or clotting problems.