Epistaxis – What it is, Causes, Symptoms and Treatments!

Epistaxis is defined  as bleeding  from the nasal mucosa. It is estimated that 60% of the adult population has already had at least one episode of Epistaxis , most of the time self-limiting and without major consequences. It is estimated that only 6% of cases of Epistaxis  require medical intervention to contain the bleeding  and the mortality rate from massive Epistaxis  is less than 0.01%3.

Causes: Epistaxis does  not have an easily identifiable cause. However, trauma to the nose  is a very common cause of Epistaxis . Epistaxis can be caused by trauma to the outside of the nose  from a blow to the face, or trauma to the inside of the nose from the nose  crop. Other conditions that predispose a person to Epistaxis  include:

• Exposure to hot, dry air for long periods of time;
• Nasal and sinus infections;
• Allergic rhinitis;
• Nasal foreign body (object stuck in the nose );
•  vigorous nose blowing;
• Nasal surgery;
• Deviated or perforated nasal septum;
• Cocaine use.

Symptoms: Epistaxis starts  from one nostril. In case of heavy bleeding  , it can fill the nostrils and overflow the nasopharynx. In certain cases, blood  may flow from the nose  through the throat into the stomach. A person is likely to vomit in such a condition. Common signs of excessive nosebleed are:

• Excessive blood loss  can cause dizziness and fainting, confusion, loss of alertness and sensation. However, the condition is rare.
• Bleeding from other parts of the body like teeth, gums, nostrils, etc. indicates inability to clot the blood .
• Additional bleeding from other parts of the body, such as bleeding gums when brushing teeth, blood  in the urine or bowel movements, or easy bruising also indicates the inability of the blood clot .

Diagnoses: As a first step in emergency care, it is essential for the doctor to make sure that it really is a case of Epistaxis . As we saw in the introduction, not all nosebleeds  come from the mucosa. Upper gastrointestinal bleeding with regurgitation through the nostrils or vascular lesion of the skull base, for example, can also present as nosebleeds, but require specific and immediate treatment.

Treatments: The first step in treating severe epistaxis  is packing the nose well , which should be performed by a properly trained physician. If that doesn’t stop the bleeding , you may need to embolize the blood vessels in your nose  .

If you have severe blood loss from  a nosebleed, it can cause severe anemia or heart dysfunction and reduced quality of life. At Mount Sinai, we can use embolization to treat severe, recurrent nosebleeds that cannot be controlled by traditional means.