Severe bleeding from the nose causes. Epistaxis (bleeding from the nose). Types of nosebleeds

Nose bleed is a symptom of diseases such as the nasal cavity (acute and chronic rhinitis, as well as benign and malignant tumors of the nose), and the body as a whole.
Nosebleeds can be the result of trauma, blood clotting disorders, hypertension, strong physical exertion.

Possible causes that can lead to nosebleeds are varied:

1. diseases of cardio-vascular system(hypertension, heart defects and vascular anomalies with increased blood pressure in the vessels of the head and neck, atherosclerosis of blood vessels);
2. blood clotting disorders, hemorrhagic diathesis and diseases of the blood system, hypovitaminosis and beriberi;
3. fever as a result of acute infectious diseases, with thermal and sunstroke, when overheated;
4. hormonal imbalances (bleeding during puberty, bleeding during pregnancy).

Blood may come out of the nose in drops or a stream. As a result of its ingestion and entry into the stomach, bloody vomiting may occur. With prolonged, and especially hidden nosebleeds, fainting: pale skin cold sweat, weak and frequent pulse, blood pressure drops.

First aid for nosebleeds:

1. It is necessary to comfortably seat the patient so that the head is higher than the body.
2. Tilt the patient's head slightly forward so that blood does not enter the nasopharynx and mouth.
3. Do not blow your nose if you have a nosebleed, as this can make the bleeding worse!
4. Press the wing of the nose against the septum. Before this, cotton swabs moistened with a 3% solution of hydrogen peroxide, naphthyzinum 0.1% can be introduced into the nasal passages (tampons are prepared from cotton wool in the form of a cocoon 2.5-3 cm long and 1-1.5 cm thick, tampons for children should be injected with a thickness of no more than 0.5 cm).
5. Put a bubble (heater) with ice on the back of the head and bridge of the nose for 20 minutes.
6. Here is a way: if there is blood nose, then you need to take paper (clean) about 6X6 cm, and quickly make a ball out of it, put the ball under the tongue. Medicine is not able to explain this phenomenon, but the blood stops within 30 seconds and you do not need to throw your head back, you just need to sit still.

In which case it is necessary to consult a doctor?

1. If the blood from the nose flows in a stream and does not stop after the attempts made to stop on your own for 10-20 minutes.
2. If nosebleeds are the result of a bleeding disorder, diabetes mellitus, increased blood pressure.
3. If the patient is constantly taking drugs such as aspirin, heparin, ibuprofen.
4. If the blood, abundantly flowing down the back of the throat, enters the throat and causes hematemesis.
5. If, against the background of nosebleeds, a fainting or pre-fainting condition has occurred.
6. With frequent nosebleeds.

Treatment of nasal bleeding is carried out by an ENT doctor.

Folk remedies for nosebleeds:

1. If blood comes from the right nostril, then right hand lift up above your head, and hold the nostril with your left, and vice versa.
2. The patient raises both hands behind his head, and the second person clamps both nostrils or one for 3-5 minutes. The bleeding will stop soon.
3. Rub fresh yarrow leaves to make them moist and insert into the nose. And even more effective - squeeze the juice and drip it into the nose.
4. Into a glass cold water squeeze the juice of 1/4 lemon or pour in 1 teaspoon of 9% vinegar. Pull this liquid into the nose and hold it there for 3-5 minutes, holding the nostrils with your fingers. Sit quietly or stand, but do not lie down. Put a wet, cold towel on your forehead and nose.
5. With frequent nosebleeds, corn stigmas will help. 1 st. spoon (with the top) of corn stigmas, pour 1.5 cups of boiling water and boil in a water bath for 10 minutes. Then cool the broth and take a quarter cup 3 times a day.
6. For nosebleeds, drink an infusion of dry herbs. Pour 3 pinches of raw materials with a glass of boiling water and cool. Strain and drink the infusion in 3 divided doses.

Nose bleed.

The most common reason nosebleeds- injuries. In some, the vessels can even suffer from a strong blowing of the nose or from the habit of picking your nose with your finger. In children, nosebleeds often occur due to inflamed adenoids or due to too dry air in the room: the parched mucous membrane cracks and breaks the blood vessel .
It happens that the blood nose goes during the flu, colds - due to illness, the vessels become fragile. They are more vulnerable during pregnancy. Another possible reason is a lack of vitamins C or K, long-term use of aspirin, heparin, ibuprofen.
Sometimes nosebleeds occur when sharp decline atmospheric pressure, long stay in the sun, physical overexertion.
Regular bleeding from the nose occurs with blood diseases, rheumatism, diabetes, chronic diseases liver. They often accompany hypertension: with a sharp rise in blood pressure, the walls of the vessels do not withstand and burst. In this case, the blood will not stop until the pressure returns to normal.

What to do about nosebleeds?
First of all, you need to calm down - with excitement, the heart begins to beat faster, and this only increases the bleeding. Then sit down and tilt your head slightly forward.
Throwing it back, as many do, is impossible in any case!
Firstly, because of this, blood can enter the esophagus and cause vomiting, and secondly, in this position, the veins in the neck are compressed and pressure in the vessels of the head increases, which increases bleeding.
Cold should be applied to the back of the head and bridge of the nose (hold for 3-4 minutes, then the same break), and heat should be applied to the legs. Pinch your nose with your fingers and sit like this for 5-10 minutes.
If the bleeding is severe, before that, you can gently insert cotton swabs moistened with hydrogen peroxide or naphthyzinum into the nostrils. In order not to damage the bleeding vessel again, the cotton wool from the nose can be removed no earlier than an hour later
It is better not to bury any drops: blood along with the medicine can get from the nasal cavity into auditory tubes and then cause inflammation of the ear.
After stopping the bleeding, you can not blow your nose for a day (so as not to dislodge the formed blood clot). Also at this time it is better to refrain from hot food and drinks. They can dilate blood vessels and cause re-bleeding.

If the cause of nosebleeds is weak vessels, you can strengthen them in the following ways:

1. rinse your nose with salt water;
2. lubricate the nostrils from the inside with petroleum jelly to protect the mucous membrane from drying out;
3. more often drink green tea, rosehip broth;
4. drink 1 tbsp three times a day. nettle infusion (3 tsp dry herb pour 1 tablespoon boiling water, leave for 20-30 minutes);
5. take ascorutin (it contains vitamins necessary for blood vessels.

Common barberry will relieve frequent nosebleeds

1/2 teaspoon of crushed barberry bark should be infused for 1 hour in a glass of boiling water. Strain and drink half a glass 3-4 times a day and rinse the nose with this cool infusion several times a week. Gradually, bleeding will stop bothering you.

Turnip for nosebleeds

Such a treatment for nosebleeds: grate a turnip, squeeze the juice, add sugar. Take 1 tablespoon 3 times a day. Bleeding will stop after 1 day, but for prevention, take the juice for another two days. There will be no more bleeding.

Nosebleed will stop horsetail

As soon as bleeding begins, it is necessary to prepare a decoction of horsetail: 1 tbsp. l. pour 0.5 l of water, bring to a boil, boil for 5 minutes, cool quickly, placing the saucepan with the broth in a large container with cold water, strain and draw in the decoction with the nose several times. The procedure is not pleasant.

Willow powder (white willow) against nosebleeds

Dried willow bark is used for nosebleeds. It must be ground in a coffee grinder. You will get a powder that needs to be inhaled through the nose. This should not be done during bleeding, but in advance. For several weeks, inhale willow powder every two days, and the bleeding will stop.

Epistaxis - Nosebleeds or Nosebleeds?

Strange as it may seem, but these two phrases, close in content, reflect completely different concepts, united by a common name - epistaxis.

Nosebleeds occur in people of various age categories. It may be spontaneous or due to various external causes that caused a violation of the integrity of multiple networks of capillaries that actively supply the mucous layer of the nasal sinuses or nasopharynx. It is with this pathology that up to 10% of patients are treated in polyclinic otolaryngological departments.

The frequent manifestation of nosebleeds can be one of the symptoms of serious pathologies. Such cases in medicine are already considered as nosebleeds, which can provoke intracavitary vascular damage to the skull or nasal mucosa.

The respiratory system, esophagus or stomach may well serve as a source of pathology. With such vascular disorders, blood flows out as a result of leakage through natural openings (choanae) connecting the oropharynx with the nasal cavity.

Forms of manifestation

Nosebleeds, according to their manifestation, are divided into several forms - mild, moderate and severe. In addition, they differ according to certain criteria:

By location- vascular lesion of the vestibule (anterior) or posterior vessels, bleeding from one sinus or bilateral.

Bleeding from the anterior parts of the nasal cavity is due to multiple branching of the vessels in the anterior zone of the Kiesselbach plexus of both nostrils. It is the defeat of the anterior circulatory system of the nose that is the main cause of nosebleeds from one nostril.

Bleeding from the posterior segment due to injury circulatory systems in the deep areas of the nose and is very dangerous. Blood loss can be unpredictable, it is almost impossible to stop it and stop it at home.

In terms of time the duration and short duration of the pathological process is determined.

The quantitative indicator is due to a profuse course (abundant), or insignificant (a small amount, drops).

According to the number of manifestations- rarely occurring (or single), repeatedly repeated (recurrent) and spontaneous (injuries or surgical interventions). The risk of recurrent manifestations is due to the development of anemia.

According to the type of vascular lesion- blood capillaries, deep arterial vessels, or venous network.

Etiology of nosebleeds

causes of nosebleeds, photo

The manifestation of epitaxis in patients of any age is due to various reasons of a general nature and local reasons among which prevail:

• drying of the mucous epithelium in a hot and unventilated room, which leads to capillary fragility. Normally, sleeping in these conditions causes nosebleeds at night.
• thinning and thickening of the intracavitary mucous membrane of the nasal sinuses during the development of specific atrophic rhinitis;
• the presence of angiofibroma of the nasopharynx, tumor-like growths (hemangiomas) or polypous formations.

What can nosebleeds tell about in adults?

The causes of nosebleeds in adults and children of a local nature are supplemented by many pathologies.

They can be caused by physiological, traumatic and compensatory curvature of the cartilaginous septum of the nose, which leads to changes air flow in both sinuses, provokes in them and in maxillary sinuses irritation and dryness, the development of long-term infectious processes, swelling and congestion, articular fragility.

Thermal, radiation and chemical burns cause necrosis of the mucosal epithelium and damage to the capillary vascular walls in the nasal cavity.

The manifestation of unilateral or bilateral epistaxis is facilitated by surgical manipulations and interventions (punctures, endoscopy, probing, piercing).

TO common reasons added:

1. Cardiovascular pathologies that provoke increased permeability of the vascular walls. Eg, different kinds atherosclerosis, causing sclerosis of the arterial walls and the development of hypertension.
2. Vascular anomalies in the cervical area and head, caused by an increase in intravascular pressure provoked by disseminated syndrome of intravascular hemostasis.
3. Pathological conditions in hemorrhagic diathesis, manifested by increased vascular bleeding due to the presence of pathologies associated with the process of impaired blood coagulation (clotting).
4. A sharp change in barrological pressure, characteristic of certain professions (for divers, pilots, climbers).
5. Pathology of the kidneys and diseases of the liver. For example, cirrhosis, accompanied by high blood pressure and severe vascular fragility, and renal pathologies often accompanies the syndrome of uremic bleeding, manifested by epistaxis.
6. Reception medicines interfering with normal hemostasis.
7. Congenital anomalies - hemorrhagic angiomatosis or hemophilia.

U absolutely healthy person signs of epistaxis can manifest themselves with prolonged exposure to the nasopharynx of frosty and dry air, causing dryness of the mucous membrane and vascular damage.

In the older generation, bleeding from the nose occurs more often, due to age-related characteristics, when the vessels in the posterior part of the sinuses lose their elastic properties, are damaged, causing posterior vascular hemorrhage.

With posterior bleeding, blood drains into the throat, and may go unnoticed and cause significant blood loss. In aged women, the cause of dystrophic changes in the mucosal endothelium and blood vessels is due to a hypertensive crisis or a natural factor in menopause.

The delicate and easily injured mucous layer of the children's nasopharynx is supplied with blood by the largest vascular branch - the artery of the neck and head. The greatest predisposition to bleeding is noted in the vessels of the lower nasal passage.

In children, the causative factors are in many ways similar to the manifestation in adults, but are also supplemented by external factor caused by pathologies in the mucous epithelial layer due to the introduction of foreign irritants - peas, pencils, buttons and many objects that young children often put into their noses.

Register of general causative factors includes:

1. Infections that cause high fever, provoked by the action of viral toxins headache and nosebleeds (cold viral infections or general intoxication with scarlet fever).
2. Diseases that cause failures in coagulation processes, or congenital pathology hemostasis systems.
3. Sunstroke and overheating, or the influence of atmospheric pressure surges.
4. Problems of intracranial and arterial pressure. More often appear in puberty as a result of overload (physical, emotional or sports-related). The blood goes through the nose, the pressure drops. The good news is that it comes out through the nose and not into the brain. This is how a kind of protection of the body is manifested, trying to stabilize the state at least for a while.
5. Hormonal adjustment - the release of hormones in children in puberty accompanied by a narrowing of capillary vessels and an increase in blood pressure. Cyclic manifestations of nosebleeds in girls are observed during the formation of the menstrual "lunar" cycle.
6. Avitominosis is an imbalance with vitamin C, manifested by vascular fragility and fragility in the spring, vitamin K deficiency is the main cause of poor hemostasis, which is manifested by epistaxis.

Epistaxis during pregnancy

Nosebleeds during pregnancy can cause various reasons. Manifestations at the beginning of the 1st trimester are caused by the restructuring of the woman's body.

Increased estrogen synthesis provokes an extensive accumulation of fluid in the intercellular space of the upper layer of the mucous epithelium and blood overflow vascular network, which provokes increased fragility and permeability of capillaries

Natural stress during pregnancy, and lying position causes increased sniffing. To alleviate the condition, the woman is forced to apply vasodilators, which dry the mucous membrane, damage the vessels and cause signs of dry rhinitis. Usually they are manifested by bleeding in the morning, even with a slight blowing of the nose.

In subsequent trimesters - the 2nd and 3rd, epistaxis may be the result of beriberi with subsequent development pathological changes in the walls of the capillaries.

The presence of hypertension contributes to pathology and provokes fetal hypoxia and problems with fetal development. In the state of pregnancy, in order to ensure fetal nutrition, blood circulation in the female body, which increases the load on the heart and blood vessels.

Not plentiful rare manifestations Epistaxis does not cause a threat, but the appearance of blood from the nose every day, threatens to terminate the pregnancy and requires timely correction and medical care.

Main symptoms of nosebleeds

The vast majority of pathologies begin without previous symptoms. TO characteristic symptoms include: vertigo (manifestation of dizziness), migraine attacks, tachycardia, hearing loss with tinnitus caused by impaired blood flow. Accompanied by hypertension and great weakness, pose a serious problem.

Different forms of pathology correspond to certain symptoms:

• In the initial form of pathological manifestations, the symptoms are manifested by insignificant blood loss with lung symptoms dizziness.
• IN mild form weakness and tachycardia, tinnitus, signs of thirst and vertigo are noted.
• The average severity of manifestation is characterized severe dizziness, shortness of breath, drop in blood pressure and tachycardia, signs of cyanotic changes in the skin.
• The severe form is manifested by hemorrhagic shock, severe lethargy, a drop in blood pressure, tachysystolic disorders, and fainting.

A severe form of bleeding with large blood loss, may become recurrent, periodically repeating to cause mental disorders due to oxygen starvation.

First aid for nosebleeds will not cause difficulties if you clearly know how to do it correctly. It is necessary to firmly grasp - it is impossible to wait for an independent solution to the problem. Serious complications from the cardiovascular system, the manifestation of fainting and anemia can aggravate the situation.

To quickly stop the blood, you need to sit down, slightly tilting your head. Press the nose with two fingers for 10-15 minutes. During this time, the blood inside should clot and block the passage of the damaged vessel. Pay attention to the fact that breathing through the mouth was free.

You can stop bleeding with the help of tamponade, after wetting the tampon with peroxide or apple cider vinegar. The tampon is inserted into one nasal opening, or both. Ice or ice is applied to the nose bridge. cold compress. For hours 2, 3, you should refrain from blowing your nose and breathing through your nose.

When bleeding from one nasal opening, for example, on the left side, it should be raised above the head left hand and vice versa if on the right side.

Helping a child with nosebleeds is similar. But with babies, be aware psychological factor because young children are usually very afraid of this condition. It is necessary to distract him, calm him down and organize medical care as soon as possible.

Diagnostic examination

Often the manifestation of a single minor epistaxis is due to a traumatic cause. In this case, a rhinoscopic examination of the anterior zone of the Kisselbach plexus gives a complete picture of the source of bleeding.

If the source is located in the deep zone of the nasal cavity, the method of endoscopic examination (probing) is used.

To determine the generalizing characteristics of the lesion (hemodynamics), in the recurrent stage, a blood examination is prescribed - a coagulogram (coagulability test), thromboelastogram, which allows you to make overall score the patient's condition based on the result of hemoglobin and platelet parameters.

Biochemical and general analyzes, blood pressure indicators, help to establish the background cause that provokes epistaxis and make the correct treatment therapy.

Methods for treating nosebleeds

Drug therapy is the main stage in the treatment. Due to the careful selection of appointments:

1. Hemostatic drugs - "Epsilon", "Abmen", calcium and hemostatic agents are widely used.
2. Enhances the therapeutic effect of Vikasol. Its appointment is justified in case of background hepatic pathology.
3. To strengthen the vascular walls, drugs are prescribed that increase hemostatic functions - Ascorutin, Vipraksin.
4. Drugs that prevent thrombosis - "Kontrykal" or "Trasilol".
5. Coagulation correctors and immunoglobulin preparations that eliminate heavy bleeding.
6. The complex therapy includes medicinal products that eliminate background pathologies that caused epistaxis.

All appointments, dosages and treatment regimen are purely individual for each patient.

1. As local treatment, to stop nosebleeds, swabs soaked in plasma or citrated (sterilized) blood, hemostatic hemostatic sponges, fibrinous antiseptic biological swabs are used.

2. For nosebleeds from small vessels, use various methods cauterization - laser cautery and electrocoagulation, cryodestruction or ultrasonic disintegration.

3. Effective action provide catheter oxygen therapy (inhalation of humidified oxygen), anterior or posterior tamponade - tampons moistened with a hemostatic preparation from long bandages are inserted into the nasal cavity to stop blood secretions.

As surgical techniques apply:

1. Vestibuloplasty - incision of the mucous membrane with and without detachment, removal of the submucosal layer from the nasal septum, scraping of granulation growths.

2. With more serious pathologies– vascular ligation, dermoplasty, replacement of the mucous membrane with a skin behind the ear flap.

Characteristics of possible complications

Large blood loss during epistaxis, can lead to acute process circulatory disorders (collapse) with a sharp violation of blood supply and acute hypoxia tissues, organs and systems. Especially, it is reflected in the brain, kidneys and heart tissues.

The progression of this condition causes shock and loss of consciousness in the patient, which, without medical intervention, can result in death.

Frequent nosebleeds are a common reason for visiting a doctor. In some cases, it even leads to hospitalization of the patient, especially if bleeding occurs after any injury. However, if there was a mechanical effect, there are no problems with making a diagnosis and prescribing treatment, but in other cases it is quite difficult to deal with the causes of the pathology. Why does the nose bleed, how dangerous is it, and what treatment can be prescribed for this condition?

There are many reasons for nosebleeds. nasal cavity good blood supply, anterior nasal septum filled with blood vessels. Even a minor blow or any injury immediately leads to bleeding. At least once every person has encountered this unpleasant phenomenon, but most often the blood itself stops after a while, and no more problems arise.

However, it is necessary to sound the alarm if nosebleeds began to occur without visible reasons, they are repeated and with great difficulty stop.

There are several common external causes:

• Solar and heat stroke. When the body overheats, dizziness, nausea are observed, a common symptom associated with an increase in blood pressure is nosebleeds. Overheating can be very dangerous, it is necessary to take the victim to a cool place as soon as possible and provide first aid.
• Intoxication, poisoning, exposure to various chemicals. Blood vessels mucous membranes are constantly exposed to negative effects from workers in chemical industries, those who work with various volatile substances, etc. chronic poisoning leads to serious disorders in the body, manifested by frequent bleeding.
• Taking antihistamine drugs and some other drugs. Long-term use of aspirin can lead to bleeding - it helps to reduce clotting and thins the blood.

In addition to external causes, frequent bleeding from the nose can occur due to various infectious diseases. Among them are tuberculosis, syphilis, the condition of the mucosa is also negatively affected by diseases of the liver and kidneys. Blood often goes through the nose with high blood pressure: in this case, the patient feels tinnitus, dizziness, weakness.

Also, frequent nosebleeds occur with increased fragility of blood vessels, bleeding disorders and other diseases of the circulatory system.

In any case, if frequent causeless bleeding is observed, it is necessary to undergo treatment as soon as possible. full examination to identify and eliminate the cause.

First aid for nosebleeds

If nosebleeds have begun, it is important to properly provide first aid to the patient. Often people start to panic at the sight of blood - this further increases the pressure and only increases the bleeding. But if you know what to do, you can easily avoid unpleasant consequences for the body.

The person must be seated, providing peace. The head does not tilt back: blood must not enter the stomach, otherwise it may provoke vomiting. You can’t blow your nose when bleeding - this will not help the patient, and the blood will be more difficult to stop. The head should be slightly tilted forward, a cotton swab is placed in the nostril: it helps to form a plug and stop the bleeding.

A cold object should be applied to the area of ​​​​the bridge of the nose - this will help constrict the vessels, and the blood will stop faster.

If the patient is unconscious, he should be placed on his back with his head turned to the side to avoid blood entering the stomach. If first aid for nosebleeds does not work, you need to call an ambulance.

Useful video on how to properly stop a nosebleed.

What can and how to make a solution for washing the nose?

When is it necessary to urgently call a doctor? Watch out for warning signs:

• Heavy bleeding that doesn't stop for a long time. It is necessary to stop the bleeding as soon as possible, and for this you have to use medical help.
• The appearance of weakness, cold sweat, black dots before the eyes. As a rule, this condition is observed with severe blood loss, which must be stopped as soon as possible.
• General deterioration of well-being. Bleeding from the nose is just one of the symptoms that may indicate a serious illness.

Treatment

Treatment for nosebleeds depends on the cause of the condition. First of all, it is necessary to exclude the impact of hazardous factors: mechanical and chemical effects, the negative effects of drugs, etc.

It is necessary to avoid overheating of the body, too intense physical exertion and other factors that can provoke bleeding. If it is not possible to immediately determine their cause, the doctor will prescribe a complete examination, based on the results of which treatment will be prescribed.

Depending on the identified cause, the doctor may choose one of the following methods of treating nosebleeds:

• If they are caused by polyps (benign tumors) in the nasal cavity, surgical treatment may be prescribed. The doctor will perform an operation and remove all formations from the nasal cavity, after which the bleeding will completely disappear.
• If bleeding occurs due to chronic or other inflammatory processes, the doctor will also prescribe special aerosols, treatment methods depend on the severity of the disease.
• If it goes due to damage chemicals, it is necessary to achieve complete elimination of the damaging factor, after which a diet is prescribed and special means with vitamins A and E. They contribute to more rapid healing and restoration of blood vessels.
• For bleeding due to long-term use blood thinners, the course of treatment has to be reviewed. Prolonged use of such drugs poses a serious threat to human health: blood can come not only from the nose, serious internal bleeding with the unpredictable.
• If they are caused by any systemic diseases complex therapy will be prescribed. It is necessary not only to remove the symptom, but to eliminate the very cause of its occurrence - it may be an infection, allergic reaction, benign or malignant tumor etc. In all cases, after removing the cause, nosebleeds will disappear.

If alarm symptom appeared at least a few times, it is necessary to start treatment. Bleeding from the nose is one of the first symptoms of such terrible diseases as cancer, diabetes, atherosclerosis, heart failure, etc. With frequent bleeding, the doctor will prescribe drugs that increase blood clotting: these are Vikasol, chloride and calcium gluconate, as well as large doses vitamin C.

Surgery

In about 10% of cases, nosebleeds have to be stopped surgically.

The doctor may use one of the following techniques:

• Cauterization of a damaged vessel with a cotton swab dipped in a solution of silver nitrate. This procedure allows you to reliably stop the bleeding due to the formation of a crust.
• In difficult cases, coagulation of the vessel is prescribed: modern technologies allow it to be carried out painlessly using a laser or electric current. Severe blood loss may even require a transfusion of plasma and donated blood.
• With local bleeding, solutions of lidocaine or novocaine can be injected directly into the mucosa. In progress surgical operation the doctor performs a cartilage resection and careful local intervention in the mucous membrane.
• Cryotherapy - freezing the damaged area with the help of liquid nitrogen. This technique avoids the appearance of scar tissue. In addition, it causes a minimum discomfort patient.

Modern technologies have expanded the capabilities of specialists: operations are carried out using the most gentle methods that do not require long recovery and allowing you to get a guaranteed result.

Possible Complications

Nosebleeds can be not only anterior, but also posterior: in the second case, blood begins to flow from the posterior wall of the nasal cavity, and in this case it is difficult to assess the amount of blood loss. If blood enters the stomach, it provokes vomiting with dark blood which will only make the patient feel worse. In this case, it is very difficult to stop the bleeding on your own, it is necessary to call ambulance and help the patient as quickly as possible.

What could be the causes of frequent nosebleeds and how they can be cured - says Olga Pavlovna Soloshenko, an otorhinolaryngologist at the Semeynaya clinic.

If the bleeding does not occur from injuries and recurs periodically, it is better not to delay the visit to the ENT. After all, bleeding can be anterior and posterior - the second happens less often, but it is much more dangerous. With anterior bleeding, blood only goes out, with posterior bleeding, it flows into the mouth or stomach along the back of the pharynx. The posterior is usually caused by a lesion of more large vessels which are located deep in the nasal cavity. It is very difficult to stop back bleeding without a doctor.

Causes of nosebleeds:

• Injuries. Injury to the nose is often fraught with cartilage fractures. As a rule, this is accompanied by swelling and pain.
• High blood pressure. A very common reason. Because of jump capillary walls break easily. Pressure rises due to overload, as well as in the presence of diseases of the cardiovascular system.
• Sunstroke and any sharp rise body temperature.
• Overwork.
• Change in hormonal background. Bleeding can occur in women during the months of pregnancy or during menopause, and in adolescents during puberty.
• Dry air. It causes dryness of the mucous membrane.
• Poor blood clotting.
• ENT diseases. Sinusitis, sinusitis, rhinitis - all of them can cause bleeding, especially with the constant use of drugs that thin the mucous membrane.
• Vascular problems. They may even lead to infectious diseases such as chicken pox, measles, influenza, etc.
• Polyps, adenoids, tumors. In addition to periodic bleeding, they simply make breathing difficult.
• Foreign body entry- can damage the mucous membranes and blood vessels.
• Deficiency of vitamins K, C and calcium.

First aid for nosebleeds:

• Sit down (or position the patient), lowering your legs down
• Tilt your head forward
• Place a cold compress on the bridge of your nose for a few minutes.
• Pinch your nose with your hand or insert a swab previously moistened with hydrogen peroxide
• You can drip drops to narrow blood vessels

Attention, this cannot be done!

• Throwing your head back (contrary to popular belief) - blood can enter the respiratory tract
• Blow your nose - so as not to increase bleeding.

What cases require an immediate call to a doctor and an ambulance

• With loss of consciousness
• With too much bleeding
• Blood flows along with a clear fluid (this can happen after an injury and indicate a fracture at the base of the skull)
• If you vomit blood (possibly indicating bleeding in the esophagus or stomach)
• Blood with foam (possible if the lungs are injured)
• In a patient with diabetes
• If the patient is known to have poor blood clotting

Treatment

Treatment of bleeding is carried out in a complex manner. Often, an otorhinolaryngologist works in conjunction with a general practitioner, neurologist, endocrinologist, and hematologist.

At the first examination, the doctor determines the type of bleeding - anterior or posterior. The patient is also required to submit general analysis blood and coagulogram (analysis of blood coagulation parameters). In addition, it is important to measure the pressure, because if it is above the norm (the absolute norm is 120/80 mm Hg, but these figures change depending on age), the blood will not stop until it decreases.

With significant blood loss, the patient may be left in the hospital.

As a treatment for bleeding, it is possible to pack the nasal cavity, cauterize blood vessels (with drugs, laser, ultrasound, etc.), and remove polyps. If there is no result, surgical ligation of the vessels is performed in problem areas. In addition, drugs are prescribed that increase blood clotting.

Prevention

• Taking medications that strengthen the walls of blood vessels
• Nutrition, rich in vitamins and minerals
• Air humidification during the heating season
• Prevention of possible injuries
• Monitoring blood pressure and taking drugs that lower it

Bleeding from the nose is not only unpleasant, but also dangerous. Therefore, as soon as it begins to bother you regularly, it is important to see a doctor as soon as possible. It is best to eliminate all the most terrible reasons such a phenomenon and then it is already calmer to engage in further treatment.

Making an appointment with an otolaryngologist

Be sure to consult a qualified specialist in the field of nasal diseases at the Semeynaya clinic.

Anyone at least once, but had to deal with nosebleeds. But not everyone knows why the nose bleeds. The reasons for this phenomenon in an adult can be very different: overwork and fatigue, nose injuries, as well as other more serious diseases.

In cases where nosebleeds are quite frequent, you need to immediately undergo medical examination to identify the true cause or disease.

Similar symptoms can signal a disease of various internal organs- liver, kidneys, and blood. In addition, nosebleeds can be caused by cardiovascular diseases, rheumatism and a variety of infectious diseases.

Classification

The volume of blood leaking from the nose can range from a few milliliters to half a liter.

1. A blood loss of a few milliliters is considered insignificant. Such bleeding is not dangerous to health and does not lead to any consequences. The only negative point may be fright, hysteria or fainting in young children.
2. Blood loss is assessed as moderate if its volume does not exceed 200 ml. Such blood loss causes slight weakness, dizziness, rapid pulse and flies before the eyes. Possible blanching of visible mucous membranes and skin.
3. ABOUT massive blood loss we are talking about cases where up to 300 ml of blood flows out in total or simultaneously. It is accompanied by more severe symptoms compared to mild degree: weakness, tinnitus, dizziness, headache, thirst, shortness of breath.
4. Profuse bleeding characterized by a large volume - 500 ml and above. Massive blood loss leads to hemorrhagic shock, expressed in plummet blood pressure, lethargy, various violations consciousness up to its loss, insufficient blood circulation in the internal organs.

Also, nosebleeds can be conditionally divided into local and general. Local are those that cause blood with local damage to the nose, and general are those that cause bleeding in general.

Why does an adult bleed from the nose: reasons

Drops or trickle of blood emerging from the nasal passages are the result of damage to the vessels. This happens as a result of either mechanical impact(nose injury), or internal processes in the body.

Let us consider in more detail the main reasons why an adult can bleed from the nose, and what to do in this case:

1. Trauma - most often, various blows to the face area lead to trauma to the nose, which may be accompanied by a fracture of its septum with the development of severe bleeding. IN childhood the habit of picking the nose with a finger or any objects (pencil, pen) leads to injuries of the nasal mucosa.
2. Impact external conditions . Long exposure to the sun, overwork, physical exercise- factors that can cause spontaneous nosebleeds. This is a solitary phenomenon, it is not a reason to go to the doctor, the blood stops quickly, and the incident is forgotten.
3. Sunstroke and overheating- one of the main factors of bleeding from the nose, especially in the summer. Because of high temperatures the nasal cavity becomes dry, and the vessels become fragile. They burst easily and cause nosebleeds. To save yourself from heat stroke, you need to wear a panama or a hat, stay in a shady place more.
4. Can cause nosebleeds drying of the mucous membranes, as the capillaries become fragile. Drying of the nasal mucosa can be the result of a long stay in a room with dry air or in the cold.

The second group of nosebleeds is caused, as a rule, by much more serious causes, consisting in systemic disorders. In this case, epistaxis is not a separate pathological condition, and the manifestation of symptoms of diseases of any organs and physiological systems, most often - respiratory and circulatory. IN this group includes diseases such as:

1. . Elevated blood pressure or can also cause nosebleeds. But this is more of a blessing than a disaster, because it is better to lose some blood and reduce pressure than to have a stroke. By the way, most often pressure drops occur from 4 to 6 in the morning. This fact explains why some people have nosebleeds in the morning.
2. Inflammatory process of the nasal mucosa() or its sinuses (,) - inflammation weakens the walls of blood vessels, making them more brittle. To development inflammatory process can lead to acute respiratory viral infection, allergic rhinitis, bacteria (streptococci, staphylococci, E. coli).
3. Papillomas in the nose- growths on the mucous membrane. Are the result viral infection, are dangerous mutations in malignant formations. Polyps put pressure on blood vessels, make breathing difficult, and cause frequent bleeding in the morning.
4. - accompanied by weak, fragile vessels, often causing nosebleeds in an adult or child diagnosed with VVD. Additional symptoms are watery discharge of blood, pain in the head, tinnitus.
5. - changes in blood vessels, loss of their elasticity, frequent damage with the occurrence of various bleeding (internal and external).
6. Pheochromocytoma is a tumor of the adrenal glands that increases the level of stress hormones. Because of this, the pressure rises sharply and constantly bleeding from the nose. Signs of this tumor are frequent nosebleeds and dryness in the nose. With such symptoms, you should contact the clinic.
7. Taking medication. As a rule, bleeding is caused by drugs aimed at preventing blood clotting. These include heparin, aspirin and others. Blood from the nose can flow with prolonged and uncontrolled use of nasal sprays that dry out the mucous membranes.
8. Oncological diseases. Epistaxis occurs with malignant and benign neoplasms in the nose. In addition to bleeding, there may be an ulcer on the nasal mucosa, swelling of the nose, and a change in its shape.
9. Diseases associated with blood clotting disorder such as hemophilia.
10. Vitamin C deficiency. As you know, vitamin C strengthens the walls of blood vessels. If it's missing, vascular walls become loose and brittle. This fact and may be the answer to the question of why nosebleeds often occur.

In the adults themselves common cause the appearance of blood from the nose is damage to the vessels of the anterior nasal septum (Kisselbach's place), densely penetrated by a network of small arterioles and capillaries. Such bleeding, as a rule, does not pose a threat to human health. The blood from the nose flows out in drops or a thin trickle and, with normal clotting, quickly stops on its own.

The situation is worse when the vessels of the upper and posterior sections of the nasal cavity are damaged. The arteries here are noticeably larger than in the anterior section, and therefore bleeding is stronger, can cause significant harm to health and even lead to lethal outcome due to severe blood loss. In this case, the blood flows in a bright red, non-foamy stream, may appear from the mouth, and practically does not stop on its own.

What to do when nose bleeds?

There is no point in treating only the symptoms, since the underlying disease must be eliminated. The causes of frequent nosebleeds are determined by the doctor. It is necessary to visit a therapist or a pediatrician and an otolaryngologist. For diagnosis, you will need to take a general blood test and check the indicators of its coagulability.

Nosebleeds may not be as harmless. Many do not pay enough attention to this. If blood from the nose worries in rare cases, and then due to mechanical impact, then there is no need to worry.

If the blood from the nose bothers you often, it spurts, or the bleeding is profuse and prolonged - all this is a signal for promptly seeking help from a specialist.

How to stop nosebleeds?

If blood flows out of the nose as a result of mechanical damage and there is little of it, and apart from a slight headache, there are no signs of serious illness, you can deal with the problem yourself. The sequence of tasks is as follows: first we stop the bleeding, then with the help of analgesics, you can reduce the intensity of pain.

Take a sitting position and slightly tilt your head back. Loosen the tie knot, unbutton the collar. Do not tilt your head forward - this will cause a rush of blood to the nose area and increase bleeding. You can’t tilt your head back either - blood will penetrate into the nasopharynx and lead to vomiting.

On the bridge of the nose, you can put a piece of ice or a towel moistened with cold water - not for long, for about ten minutes. A cloth moistened with cold water can also be applied to back side neck. It is advisable to press the nostril from which blood flows for 5-10 minutes until the bleeding stops. If the bleeding is intense or does not stop, then use tampons. For this, cotton swabs moistened with hydrogen peroxide are suitable, they must be inserted into the nose, but not too deep, and sit for 10-15 minutes.

If there is no tampon and hydrogen peroxide, then insert a bandage into the nostril from which blood flows, leaving at least 10 centimeters outside so that it can be freely removed from the nostril. This is done in order to prevent the exit of blood from the nose. Also if you have vasoconstrictor drugs, for instillation of the nose, then apply a few drops to the swab and insert it into the nose. These drops will help tighten the damaged vessel, which caused the bleeding. Then place the person in a cool, quiet and dark room. Sometimes these measures are enough.

If the bleeding is profuse and it cannot be stopped quickly enough at home, the head hurts badly, speech, vision or consciousness as a whole are impaired, urgently call an ambulance.