What is epistaxis?
“Epistaxis” is the medical term for a nosebleed. A nosebleed, meaning a loss of blood from the tissue that lines the inside of your nose, can occur in one or both nostrils. Usually, it only affects one nostril.
Your nose has many tiny blood vessels in it. These vessels help warm and moisten the air you breathe. But they lie close to the inner surface of your nose. When air moves through your nose, it can dry and irritate your blood vessels. This makes them very easy to injure or break, causing a nosebleed.
What causes a nosebleed?
A nosebleed occurs when one of the blood vessels in the tissue lining of the nose bursts. Nosebleeds may be caused by injury, infection, blood clotting issues, medication, allergic reaction or structural issues in the nose. They are usually harmless although they may be a sign of an underlying condition and can cause a great deal of distress if they are severe or very frequent.
Types of nosebleeds
There are two main types of nosebleeds. Healthcare providers describe epistaxis by the site of the bleeding.
- Anterior nosebleed An anterior nosebleed starts in the front of your nose on the lower part of the wall that separates the two sides of your nose (septum). Capillaries and small blood vessels in this front area of your nose are fragile and can easily break and bleed. This is the most common type of epistaxis and usually isn’t serious. These nosebleeds are more common in children. You can usually treat these nosebleeds at home.
- Posterior nosebleed A posterior nosebleed occurs deep inside your nose. A bleed in larger blood vessels in the back part of your nose near your throat causes this type. It can result in heavy bleeding, which may flow down the back of your throat. You may need medical attention right away for this type of nosebleed. This type is more common in adults.
What are the treatments for epistaxis?
Nosebleed treatment depends on the cause of the bleeding. Epistaxis treatment may include:
- Nasal packing: Your healthcare provider will insert gauze, special nasal sponges or foam, or an inflatable latex balloon into your nose to create pressure at the site of the bleed. Your provider may want to leave the material in place for 24 to 48 hours before removing it.
- Cauterization: This procedure involves applying a chemical substance (silver nitrate) or heat energy (electrocautery) to seal the bleeding blood vessel. Your provider will spray a local anesthetic in your nostril first to numb the inside of your nose.
- Medication adjustments/new prescriptions: Reducing or stopping the amount of blood-thinning medications can be helpful. In addition, medications for controlling blood pressure may be necessary. Your provider may prescribe Tranexamic (Lystedaâ®), a medication to help blood clot.
- Foreign body removal: If the cause of the nosebleed is a foreign object, your provider will remove it.
- Surgery: Surgical repair of a broken nose or correction of a deviated septum (septoplasty) if this is the cause of the nosebleed.
- Ligation: In this procedure, your provider will tie off the culprit blood vessel to stop the bleeding.
- Nose cautery – treatment for nosebleeds Nose cauterisation, also known as nasal cautery, is a minor procedure used to treat nosebleeds (also known as epistaxis). In nose cauterisation, a small chemical cautery stick is applied to the mucous membranes in the nose to stop bleeding.
This procedure is often performed with local anaesthetic or it may be conducted in an operating room under general anesthesia. Sometimes, nasal cautery is carried out at the same time as other procedures such as septoplasty or sinus surgery, to improve nasal breathing.