Epistaxis/Nosebleed Causes, Symptoms, & Treatment

What is Epistaxis?

Epistaxis/Nosebleed Causes, Symptoms, & Treatment.

In simple words, the condition of bleeding from the nose is called epistaxis.

Epistaxis, or bleeding from the nose, is a result of rupture of the blood vessels due to a trauma, or accident, or injury to the nose.  

This disease is seen more in children under 10 years of age and over the age of 50 and male are more susceptible than female.

Types of Epistaxis/Nosebleeds -

There are two types of epistaxis is found, which is classified according to their site of derivation. Both types of bleeding are the following -

Anterior epistaxis/nosebleed -  

Anterior nosebleed is very common and they are often cured by simple treatment or care because the source of bleeding is obvious in 90% of the cases. 

Fortunately, this kind of nasal bleeding is not found as serious as we often think and occurs more in older people that generally can be managed with home remedies or general vasoconstrictors (ephedrine, vasopressin, phenylephrine, oxymetazoline etc.)

Posterior epistaxis/nosebleed - 

This type of nasal bleeding is rare and requires prompt and proper treatment. The patient needs hospital admission.

Are Nosebleeds Serious?

It is a fact that most patients get rid of the disease soon with proper medication. Some people who suffer from severe nasal bleeding, which can dependably be out of the danger.

What Causes Nosebleeds/Epistaxis?

Nasal dryness and irritation.

Blood associated diseases like Hemophilia, Leukemia, Blood dyscrasias, Anemia.

Usage of certain medications like anticoagulants or blood thinner (heparin, warfarin, aspirin,  clopidogrel, desmopressin, fexofenadine, etc.)

Common cold, allergic or nonallergic rhinitis.

Acute or Chronic Sinusitis.

An injury or trauma (accident, fractures, a digital manipulation, usage of the feeding tube, nasal cannula, nasal intubation etc.) of the nose.

Nasal polyps, tumor (nasopharyngeal carcinoma, papilloma, fibroma, squamous cell carcinoma  or angiofibroma), surgery

Foreign body in the nose like fingering inside nasal cavity or nose picking.

Hypertension/High bloodpressure.

Prolonged use of nasal steroids

Excessive usage of Cocaine or alcoholic beverages.

Environmental or Chemical irritants (ammonia, cigarette smoke).

Hereditary hemorrhagic telangiectasia, septal spurs (anatomical deformities)

ITP - (Idiopathic thrombocytopenic purpura)

Cardiac failure.

Exposure to dry air.

Nasal bleeding associated to the second trimester of pregnancy due to high blood pressure and hormonal changes).

Platelet disorders and deviated nasal septum.

Deficiencies of vitamin K and C. 

Envenomation bypoisonous snakes like mambas, kraits etc.

Von Willebrand's disease, Osler-Weber-Rendu syndrome, Hemorrhagic telangiectasia.

Chronic liver disease/ liver-cirrhosis.

Symptoms of Epistaxis or Nosebleeds

The blood comes from the nose. In general, bleeding occurs only from one nostril. However, blood can come from both nostrils and this is mostly due to injury or trauma. Giddiness, loss of alertness, confusion, light-headedness, fainting, headache, weakness due to excessive blood loss. However, excessive bleeding is rare. 


An excessive bleeding is found in certain cases such as hemophilia, platelet disorder, in which blood clotting capacity often decreases greatly. Additional bleeding from teeth and gum pointed out to such cases. Unnecessary usage of anticoagulant drugs can also increase the risk of nose bleeding. The cause of nosebleed problems in older people is due to hypertension and dryness or thinness of the nasal mucosa.

Diet regimen, Treatment & Lifestyle Advice for Epistaxis (Nosebleed)

Ayurvedic cure, home remedies, medical approaches to the treatment of epistaxis may include the next:

Stay away from hot, and spicy foods, if you have a tendency to suffer from nosebleeds repeatedly.

Keeps the nasal passages lubricated and for this purpose use a few drops of coconut oil inside the nose.

Plugging of the cotton ball soaked in vasoconstrictor liquid that has the characteristics of contraction of the walls of blood vessels is necessary to check bleeding from the nose.

Always drink an adequate amount of normal water, coconut water, grapes or orange juices, milk etc.

Have a great amount of sleep and avoid keeping awake during night time.

Take medications to control underline causes of epistaxis like antibiotics, antihypertensive drugs, and vitamin K etc. under the supervision of the doctor.

Nasal packing should be adopted as soon as possible.

Apply medicated ointment or jelly inside the nose.

How to Prevent Epistaxis/Nasal bleeding

Laborious works like weight lifting, straining works, heavy workouts should be better avoided.

Stay far from strong nose-blowing or nasal rubbing.

Apply direct nasal pressure with fingers for 5 - 10 minutes.

An effort of crust removal with help of putting a finger inside the nostrils is also avoided.

Head elevation is very necessary in case of epistaxis to stop nasal bleeding. For this purpose, make use of one or two pillows during sleeping time.

Avoid trauma or any kind of injury of the nose.

Do not overuse decongestants, or antihistaminic nasal sprays, as these can cause dryness of the nasal mucosa, and as a result, nasal bleeding can occur.

A nasal spray of saline water should be followed to deal with nasal bleeding.

Caessation of tea, coffee, and alcoholic beverages is necessary.

Make an effective distance from high-temperature environments. For this motive, do not play or walk in the hot sun.

On the account of hypertension, always keep an eye on your blood pressure because high blood pressure may increase the risk of nosebleeds.

Avoid nose picking, or rubbing and fingering inside nostrils to prevent or stop nose bleeding.

Stop usage of cocaine, amphetamines, cigarette smoking etc.

Stay far from anticoagulant medicines like heparin, aspirin, enoxaparin, warfarin etc.

Antibiotics should be taken to prevent secondary infection and complications as well.

Baloon pressure therapy is another important treatment and should be adopted after the recommendation of an ENT specialist.

Electrocautery method - If all above stated measure proved unsuccess, chemical cautery with silver nitrate can be followed or other surgical methods should be adopted to treat nasal bleeding.

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WRITTEN BY  RAJESH  KUMAR