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Nosebleeds: When Should You See an ENT?

Everyone has dealt with a bleeding nose at some point in their lives. The condition occurs when blood vessels burst in the nasal cavity, nasopharynx, or nostrils. Although nosebleeds can be alarming due to the amount of blood hemorrhaging from the nose, in most cases, they can be managed and are not necessarily a cause for alarm. Nosebleeds are a common occurrence for all ages. However, there are cases where nosebleeds require medical attention from an ENT specialist.

The medical term for nosebleeds is epistaxis. Nosebleeds often occur after trauma to the nose or nasofacial area, damaged blood vessels, certain medications (i.e. blood thinners), abnormal or diseased nasal tissues, inflammation, sinusitis, and nasal surgery. Because it's not always easy to deal with nosebleeds, especially when they become a frequent occurrence, it’s important to learn the warning signs that mean ENT treatment is necessary.

  1. Types of Nosebleeds
  2. Common Causes of Nosebleeds
  3. How to Manage Nosebleeds
  4. Signs of When to See an ENT for Treatment 
  5. ENT Treatments for Nosebleeds
  6. Preventing Nosebleeds 

Types of Nosebleeds

In most cases, epistaxis originates from damaged blood vessels in the nasal septum. These vessels are extremely delicate, and it doesn't take much for them to break. Nosebleeds are often diagnosed as anterior and posterior. When vessels in the front of the septum break and bleed, the condition is diagnosed as anterior. A hallmark sign of anterior nosebleeds is when blood drains from one nostril.

Posterior nosebleeds, on the other hand, originate in the back of the nose and flow down into the throat. Posterior nosebleeds are usually more serious than anterior nosebleeds. Of the two types of epistaxis, anterior nosebleeds are the most common. They are more likely to occur with old age and certain medical conditions and types of trauma. Body positioning is an important factor when determining the type of nosebleed present. Before making assumptions, patients should make sure they are sitting or standing up to identify the area of the nose the blood is flowing from. 

Common Causes of Nosebleeds

Most of the time, nosebleeds occur suddenly, and there is no direct or known cause. The following conditions are known to cause the blood vessels in the nose to burst and bleed.

  • Dry air (most common cause of anterior nosebleeds)
  • Rubbing the nose
  • Foreign objects in the nose
  • Injury/trauma
  • A deviated septum
  • Allergies
  • Sinus infection
  • Pregnancy
  • Alcohol
  • Certain medical conditions
  • Certain medications or drugs
  • Nasal polyps or tumors
  • Hereditary factors

How to Manage Nosebleeds

Nosebleeds can happen at any time. Unless the bleeding is severe, gushes from the nose, or is accompanied by pain, you can use the following pointers to stop the bleeding.

  • ENT treatment for nosebleedsSit down and plant your feet firmly on the floor.
  • Breathe through your mouth while looking straight ahead to keep the blood from draining into your throat. 
  • Firmly pinch the fleshy part of your nose along your nostrils for 5 to 15 minutes without letting go to look.
  • Place a cold compress on the bridge of the nose while holding your head straight and along the back of your neck to cause vessels to spasm.

If the above steps fail to stop the bleeding, you should get medical attention right away by going to the ER.

Signs of When to See an ENT for Treatment

It can be quite distressing when nosebleeds occur, and although they can get messy, they are not always a cause for alarm. However, if you experience them a few times a week or have trouble managing the bleeding after 20 minutes, or notice any of the following symptoms, you might be a good candidate for ENT treatment.

  • Nasal congestion
  • Thick or discolored mucus
  • Decreased smell and taste
  • Coughing
  • Ear pain
  • Halitosis
  • Fever
  • Fatigue

ENT Treatments for Nosebleeds

Treatment depends on the cause and origin of the bleeding. After carefully evaluating the patient’s nose, symptoms and diagnostic tests, an ENT doctor may recommend the following treatment options.

  • Medications or moisturizers for the nose
  • Foreign object retrieval
  • Nasal packing to stop bleeding
  • Septoplasty to repair a deviated septum or other structural irregularities
  • Chemical or electrical cauterization to seal the damaged vessels to prevent bleeding

Antibiotics may be prescribed in addition to nasal surgery, packing or cauterization to help prevent infection.

Preventing Nosebleeds

Nosebleeds are normal and, in many cases, preventable. Below are some useful strategies that help reduce the severity and frequency of epistaxis.

  • Keep the nasal passages moist with saline nasal spray and rinses 
  • Moisten the air indoors with a humidifier
  • Avoid placing fingers and objects in the nose and especially picking the nose
  • Avoid certain medications that thin the blood or contribute to clotting disorders
  • Keep the nasal passages moist with saline nasal sprays multiple times a day
  • Use antihistamines and decongestants sparingly
  • Place Vaseline ointment along the nostrils before sleep to prevent dryness

If you or a loved one experiences recurrent or frequent nosebleeds, it’s time to see a CV/ENT Surgical Group ENT specialist. Call 818-431-2769 today to schedule an appointment.

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