The causes of nosebleeds are usually a minor trauma or a minor runny nose in the course of a cold. However, sometimes blood from the nose may fly due to serious medical conditions, such as high blood pressure, arteriosclerosis, and even cancer. What are the causes of nosebleeds?

Nose bleedingis blood loss from damaged blood vessel walls in the nose. The most common causes of this condition are local trauma and a drying out of the nasal mucosa. Less common causes of nosebleeds are serious diseases, such as, for example, coagulation disorders or even cancer.

Bleeding from the nose can be of varying severity, ranging from leakage in drops to serious bleeding.

The majority (80-90%) of bleeding comes from the vascular plexuses in the anterior-lower part of the nose (Kiesselbach's or Little's plexus), as these are areas of the nasal mucosa that are very vascularized, and additionally thin and sensitive to injuries .

These types of bleeding are not very intense and are usually stopped by either pinching both sides of the nose for 10 minutes or by placing a cotton ball moistened with a decongestant in the nose.

Less frequent, but more serious, are bleeding that originates in the posterior part of the septum above the sharebone or to the side of the inferior and middle auricles.

This type of bleeding can be difficult to control - sometimes hospitalization is necessary.

It also happensalleged nose bleeding-pseudoepistaxis- this is a type of bleeding that does not come from the nose, but from another part of the body . Then the blood only flows down to the nose. This type of bleeding may occur in cases of haemoptysis, esophageal varices, vomiting blood, and tumors that bleed in the throat, larynx, trachea, or lungs.

Epistaxis - local causes

  • local trauma- one of the most common causes of nosebleeds is local trauma - strong cleaning of the nose by blowing or using an organ, picking the nose. The cause of damage to the blood vessel wall can also be a strong sneeze or a violent cough, e.g. in whooping cough, and the difference in barometric pressure, caused by a rapid ascent, e.g. by plane
  • drying of the mucosa- when the nasal mucosa is dry, there are, among others,nasal dryness and blockage, decreased sense of smell, crusts that cover the lining of the nose, headaches. Inflammation is common (e.g. pharyngitis, sinusitis or otitis media). This type of ailment usually affects people staying in air-conditioned, overheated and insufficiently moistened rooms
  • erosion of the nasal mucosa- a slight defect in the nasal mucosa appears, sharp, burning pain
  • tumor(benign or malignant) of the nasopharynx or lateral sinuses - a tumor in the nose or nasopharynx is visible, bulging of the side wall of the nose
  • nasal septum perforation -defect in the nasal septum is manifested by an audible whistling on breathing, a feeling of dry nose, drying of secretions and enlargement of the nasal turbinates
  • nasal polyps -there is a runny nose or a purulent runny nose and the associated difficulty in breathing, voice changes, snoring, nasal distortion
  • infectionlocal - e.g. rhinitis, runny nose, allergic rhinitis, rhinitis
  • foreign body in the nose- frequent recurring bleeding is characteristic, combined with an odorous discharge
  • nose surgery , e.g. nose septum correction, nose plastic surgery
Important

Epistaxis resulting from an accident should not be taken lightly. They may signal a fracture of the jaw, eye socket or base of the skull. Life threatening is damage to the so-called carotid siphon, which can present as massive recurrent nosebleeds immediately after or even weeks after the injury.

Epistaxis - systemic causes

  • systemic diseases (e.g. AIDS, sarcoidosis)
  • granulomatous diseases, e.g. Wegener's granulomatosis
  • infectious diseases, e.g. influenza, measles, rubella, chicken pox, infectious mononucleosis
  • coagulation disorders, e.g. thrombocytopenia, haemophilia
  • liver failure
  • kidney failure
  • hormonal disorders
  • atherosclerosis
  • hypertension
  • Rendu-Osler-Weber syndrome
  • blood diseases - anemia, leukemia
  • vitamin C and vitamin K deficiency
Important

Bleeding from the nose during pregnancy

Bleeding from the nose in pregnancy is associated with increased blood flow and blood pressure. As a consequence, the blood vessels in the nasal mucosa widenand reducing the strength of their walls. If the pressure is too high, the vessels burst. So if your nose bleed in pregnancy is not accompanied by other disturbing symptoms, don't worry.

Bleeding from the nose - causes. Drugs

Epistaxis can be caused by drugs that disrupt blood clotting, e.g. acetylsalicylic acid (so-called aspirin), because the salicylates contained in it reduce blood clotting and can themselves cause nosebleeds, other NSAIDs and various antiplatelet drugs, e.g. heparin and its derivatives and warfarin.

Also, prolonged use of decongestants in the mucosa, such as drops and sprays containing oxymetazoline or xylometazoline, may contribute to nosebleeds.

Bleeding from the nose - causes. Chemicals

Inhaling intense chemical smells can also cause nosebleeds, as this causes damage to the blood vessels of the nasal septum. This ailment may affect, for example, painters, sales assistants of paint shops, perfumeries.

About the authorMonika Majewska A journalist specializing in he alth issues, especially in the areas of medicine, he alth protection and he althy eating. Author of news, guides, interviews with experts and reports. Participant of the largest Polish National Medical Conference "Polish woman in Europe", organized by the "Journalists for He alth" Association, as well as specialist workshops and seminars for journalists organized by the Association.

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