Why do people get nosebleeds

Nosebleeds

Nosebleeds(Epistaxis): Sudden leakage of blood from one or both nostrils, mostly due to injuries to the vascularized nasal mucosa.

The most common causes are violence or severe dryness of the nasal mucosa. Nosebleeds are usually harmless and only rarely lead to bleeding to death - the risk of the blood being accidentally inhaled or entering the stomach causing nausea is much more real.

Note: The blood loss from the nose is usually overestimated (as little as 5 milliliters can soak a handkerchief). As a result, bleeding from the nose almost always looks more dramatic than it is.

Right nasal cavity from an endoscopic perspective: blood is deposited on the turbinate.
Prof. Dr. med. Gerhard Grevers, Starnberg

Leading complaints

  • Light to heavy bleeding from the nose

When to the doctor

In the next few days if

  • repeated nosebleeds occur.

Immediately if

  • Nosebleeds are the result of forceful action on the head or nose.
  • the bleeding does not stop after 30 minutes (in children after 20 minutes).

The illness

One of the tasks of the nasal cavity is to warm the air we breathe. For this purpose, the nasal mucous membrane is criss-crossed with a dense network of blood vessels. The most frequent source of nosebleeds is the Kiesselbachii locus, a particularly vascularized area in the area of ​​the nasal septum.

causes

  • Result of violence, e.g. B. with a broken nose or with small children by "nose picking" or a foreign body in the nose.
  • Drying out of the nasal mucous membrane due to dry room air (overheated rooms in winter, air conditioning in summer) or viral and allergic inflammation of the nasal mucous membrane. The affected areas often heal poorly, so that the scabs that have formed keep tearing off and nosebleeds occur repeatedly.
  • Less common: bent nasal septum, severe high blood pressure, febrile infections (e.g. measles) and blood clotting disorders or the use of anticoagulant medication.

Diagnostic assurance

The doctor does an endoscopic examination of the nose to identify the source of the bleeding. He pays particular attention to dry and cracked areas of the nasal mucosa.

If there is suspicion that an internal illness caused the nosebleed, internal examinations such as a blood count, the determination of the coagulation factors or a blood pressure measurement are also carried out.

treatment

Once the doctor has found the source of the bleeding, he seals it by chemical burns with silver nitrate or a laser. Sometimes a decongestant nasal spray is enough to contract the blood vessels.

If no source of bleeding can be identified that can be specifically closed, the nose must be tamponized. To do this, the doctor inserts a gauze strip soaked with ointment (e.g. Tampograss®) or a special gel foam into the nose.

Are underlying internal diseases such as B. coagulation disorders or febrile infections responsible for the nosebleed, these are also treated.

forecast

In the vast majority of cases, nosebleeds are bothersome, but harmless. If there is an underlying disease, it must of course be treated. "Normal" nosebleeds, which are common in children, occur less and less with age because the vessels become more robust.

Your pharmacy recommends

What you can do yourself

Initial measures.

Epistaxis is a common, mostly harmless, symptom that you can usually stop without medical help. As a first step, sit up straight to reduce the blood supply to the head. Bend your head forward slightly so that the blood does not run down your throat and you do not swallow it. It is best to spit out the blood that gets in your mouth. Now press both nostrils firmly against the nasal septum with your thumb and forefinger for ten minutes. A cold rag or an ice pack on the neck will also help. If the nose is still bleeding after these measures, pinch your nose for another ten minutes. If the bleeding does not stop after half an hour, it is time to see a doctor.

Appropriate medication

Sensitive nasal mucous membranes can be treated with Vaseline or a special nasal ointment (e.g. Bepanthen® eye and nasal ointment with dexpanthenol or GeloSitin® with sesame oil).

Prevention

Strengthen circulation.

Many people have a lifelong nosebleed tendency. The walls of the blood vessels on the nasal mucosa are extremely thin, and the slightest irritation easily rips open such a vessel. Children usually injure the blood vessels when picking their nose - in adults it is more likely to be stress, a cold or another illness that announces itself in this way. If you have too frequent nosebleeds, you should try to find out what factors trigger the nosebleed. Many benefit noticeably from general circulation-strengthening measures such as regular sauna visits or endurance sports.

Humidify air.

It is also advisable to keep the room air as humid as possible. Especially in winter, centrally heated or air-conditioned rooms have air that is too dry (relative humidity <50%). This can be remedied by evaporation vessels on radiators or large potted plants. The humidity also increases if you only heat the rooms moderately - because with every degree above 20 ° C, the relative humidity drops by a few percent.

If you want to moisten your nasal mucous membranes from the inside, you can rinse your nose regularly with the help of a nasal douche. Many patients find sea salt water particularly pleasant. Additional effect of the nasal douche: allergens, germs and foreign bodies are removed at the same time.

Authors

Prof. Dr. med. Gerhard Grevers; Dr. Ute Koch; Thilo Machotta; Dr. med. Arne Schäffler in: Gesundheit heute, edited by Dr. med. Arne Schäffler. Trias, Stuttgart, 3rd edition (2014). Revision and update of the sections "Confirmation of diagnosis and treatment" and "Your pharmacy recommends": Dr. med. Sonja Kempinski | last changed on at 11:40


Important note: This article has been written according to scientific standards and has been checked by medical professionals. The information communicated in this article can in no way replace professional advice in your pharmacy. The content cannot and must not be used to make independent diagnoses or to start therapy.