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Epitaxis

Epistaxis or nosebleeds can seem dramatic and frightening to anyone. But in most cases it is not serious and does not require medical attention. Epistaxis is categorized depending on which part of the nose it originates – from its front or back.

In most cases, the bleeding originates from the front of the nose. Bleeding is most often due to a Keiselbach plexus, which is a tangle of several blood vessels. Such bleeding can be controlled at home and consultation with a specialist is not required.

Bleeds from the back of the nose are much less common and people in old age more prone to them. Bleeding is usually from an artery at the back of the nose. This type of bleeding is more serious and usually requires hospitalization and is managed under the supervision of an otolaryngologist.

1 in 7 people develop epistaxis at some point in their life. Nosebleeds occur more often in the winter months and in dry and cold climates.

They can occur at any age, but are most common in children aged 2 to 10 years and in people older than 50 to 80 years. For unknown reasons, nosebleeds occur most often in the morning hours.

What are the symptoms?

Bleeding is usually from only one nostril. If the bleeding is too severe, the blood can fill the affected nostril and overflow into the nasopharynx – the area where the two nostrils meet, causing simultaneous bleeding from the other nostril.

Blood may also begin to flow to the back of the throat or down to the stomach, causing spitting up and even vomiting of blood.

Symptoms of excessive blood loss are:

• Dizziness;
• Weakness;
• Confusion;
• Seizures;

Fortunately only in rare cases does excessive blood loss occur.

What are the causes?

In most cases, it is difficult to determine the cause of nosebleeds. However, traumais the most common cause of epitaxis.

Bleeding may be due to trauma to the outside of the nose from a blow to the face or internal injury from a blunt cut to the nose. Other factors that predispose to epitaxy:

• Exposure to warm and dry air for an extended period of time;
• Infections of the nose and sinuses;
• Allergic rhinitis;
• Foreign body in the nose – sticking some object in one of the nasal septums;
• Nasal surgery;
• Distorted or perforated nasal septum;
Cocaine use;

Rarely, the progression of some disease or taking some medications can cause nosebleeds or can make it difficult to control. For example, difficulty in blood clotting is most often caused by drugs such as warfarin and clopidogrel bisulfate.

Epitaxis treatment

How to stop a nosebleed?

• Keep calm;
• Stand upright and put your body slightly forward.
• Bend your head forward. Tilting the head back will cause the blood to be swallowed.
• Pinch both nostrils with your thumb and forefinger and hold for about 10 minutes, during which time you will be breathing through your mouth. You must make sure that you have not relaxed your nostrils earlier.
• Spit out any blood from the mouth, as swallowing it may induce vomiting.
• This technique will has stopped nosebleeds in most people.

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