Bleeding from nose or nosebleed (also known as Nakseer) is very common. Medically, it is known as epistaxis. It happens when a small blood vessel inside the nose lining bursts and bleeds. The lining of the nose has lots of tiny blood vessels, which warm the air as it enters the nose. This lining is very fragile and may break easily, causing bleeding.
It is a symptom as well as a sign of certain diseases. This condition is not life-threatening. There can be many reasons for epistaxis. It can be caused by very cold/dry air, allergies, sneezing, injury to the nose, or during hot weather. Nosebleeds can occur at any age but are twice as common in children.
Causes for Nosebleed
- Vascular causes: It is seen in those areas of the nasal cavity where two branches of major arterial supplies join with each other, like in the middle portion of the nose (which is known as medial turbinate). It is sometimes referred to as vascular causes of epistaxis.
- Weak vessel: Sometimes in certain disorders like Telangiectasia (which is the weakness of the capillary wall of a blood vessel) can be a cause of bleeding.
- Sudden force: Rupture of vessel wall which is caused by trauma, in an accident or as result of operative surgeries may lead to bleeding. This bleeding can be sudden which can be seen as a result of a sudden rise of vascular pressure as in nose-blowing, sneezing, coughing, straining, and in some cases of pregnancy.
- Infections: In certain infection which causes hemorrhage can lead to bleeding.
- Vitamin deficiency: Deficiency disease like deficiency of Vitamin C and Vitamin K, in liver disease can lead to bleeding from nose malnutrition can be a cause of it.
- Few Disorders of blood: Any platelet disorder like purpura, usage of aspirin, hemophilia (a disorder in which there is a delay in stoppage of blood which leads to excessive blood loss) can lead to epistaxis.
- Trauma: physical trauma like blows fractured nose, nose picking can lead to blood from the nose. It is often seen in summer as thermal trauma like overexposure can lead to blood from the nose. Any foreign insertion in the nasal cavity can lead to epistaxis.
- Infectious diseases: There can be certain infections like acute rhinitis (inflammation of the mucous membrane lining the nose usually associated with nasal discharge), sinusitis atrophic rhinitis (a chronic disease that is characterized by purulent inflammation of the nasal mucosa, atrophy of the nasal conchae, and abnormal swelling and distortion of the face) and causes like diphtheria, tuberculosis, syphilis, measles, acute malaria, typhoid, influenza, Leukaemia, can lead to blood from nose.
- High Blood pressure: Hypertension is the commonest cause of this disease. Diabetes is another important cause of this disease.
A very common cause of epistaxis is the drying of the nasal mucosa. Sometimes pressure changes at high altitudes can also cause bleeding from the nose. In some cases, no definite cause is not found.
Affected Age groups
- In children, it is seen as spontaneous or due to nose-picking. Other causes are injury to the nose, some type of fever, diphtheria.
- In adults, it is a result of trauma and sinusitis. The most important cause is juvenile nasopharyngeal angiofibroma which is seen in males.
- In adults it is seen as a result of acute and chronic sinusitis, injury to the nose while playing, boxing, head injury.
- In the Elderly, it is seen as a result of hypertension.
Symptoms of Epistaxis
It is of sudden onset. In some cases, there is past history of hypertension or injury. Bleeding may be mild, moderate, or severe.
Bleeding may be of two types-
- Bleeding is from the front part of the nose which can be visibly seen.
- Bleeding can be the backside of the nose and blood comes out through the oropharynx and oral cavity.
- Sometimes a patient may be swallowed and may be vomited put subsequently.
- The patient may progress to a state of shock if the bleeding is severe and for a prolonged period.
Laboratory test for Epistaxis
- Complete Blood Count with platelets
- Prothrombin Time
- Partial Thromboplastin Time
Emergency Treatment
Applying direct pressure by pinching the soft fleshy part of the nose. Pressure should be firm and be applied for at least five minutes and up to 20 minutes, tilting the head forwards helps decrease the chance of nausea and airway obstruction.
Homeopathic treatment of Nosebleed
For medicinal management of epistaxis following homeopathic medicines are prescribed according to the associated symptoms.
Agaricus
In this remedy bleeding from the nose is generally seen in old people who do not want to do any work. Blood from the nose comes out from blowing the nose, in the early morning, immediately after rising. This is followed by violent bleeding from overwork. There is profuse fetid discharge from the nose. In general, there is jerking twitching, trembling, and itching is a characteristic symptom. A special delirium is seen inpatient sings, talks, but does not answer. The patient is very talkative.
Worse from-Open cold air, after eating, in cold weather, before a thunderstorm.
Better from- Moving about slowly.
Dosage: Take in 30 C potency. 3 pellets 3 times a day with less frequency as improvement is made.
Ammonium carb
Nose bleeding is seen in early hours in morning on washing face, after dinner, after repeated sneezing, especially if after the flow has ceased a bloody mucus is often blown from the nose. Blood from nose with dry coryza, especially at night. Characteristic feature of the remedy is blood rushes to tip of nose when stooping. It is suitable for stout women who are always tired and weak, take cold easily, and suffer from cholera-like symptoms before menses. This women leads a very sedentary life, and does not to do any work. The women is very sensitive to cold air. Great aversion to water, cannot bear to touch it.
Worse from Evening from cold, wet weather, wet applications, washing between 3 to 4 a.m and during menses.
Better from- lying on painful side and on stomach, in dry weather.
Dosage: Take in 200 potencies. 3 pellets 3 times a day with less frequency as improvement is made.
Arnica
Blood from nose, which is preceded by tingling sensation. Bleeding occurs after every exertion from mechanical causes after washing face, during whooping cough. Bleeding is generally seen in growing children, discharge of several drops of thin blood from nose on first blowing it in the morning.
Blood is bright mixed with clots and leaving a bruised sensation behind. It is especially suited to cases when any injury. Given to treat after-effects of traumatic injuries, overuse of any organ. There is a bruised feeling in the body.
Worse from Least touch, motion, rest wine, damp cold.
Better from- lying down, or lying with head low.
Dosage: Take in 200 potencies. 3 pellets 3 times a day with less frequency as improvement is made.
China
There is habitual bleeding especially in the morning from 6-7, and often renewed. The repeated flow of blood cause the patient to feel weak and anaemic, with humming in the ears, pale face, and fainting spells. There is debility from exhausting discharges, from loss of vital fluids, together with nervous weakness. Periodicity is most marked. It is a very useful remedy for post-operative gas pains, with no relief from passing it.
Worse from- on slightest touch, from the air, every other day, loss of vital fluids, at night, after eating, bending over.
Better from- bending double, hard pressure, open-air, warmth.
Dosage: Take in 200 potency. 3 pellets 3 times a day with less frequency as improvement is made.
Crocus Sativa
Discharge from one nostril of very thick stringy black blood, with cold sweat in large drops on forehead, suits women who menstruate long and profusely and are subject to fainting at the approach of menses. Epistaxis is seen in overgrown, delicate children. There is the yellowish, sallow color of the face and sour taste in mouth.
Worse from-Lying down, hot weather, warm room, in the morning, fasting. before breakfast, looking fixedly at an object.
Better from-open air.
Dosage: Take in 30 C potency. 3 pellets 3 times a day with less frequency as improvement is made.
Hamamelis
In this remedy flow passive, with a feeling of tightness in the nose. There is profuse bleeding of which cause is not known. It is especially in young, anaemic girls. There is haemorrhages in this remedy. There is bruised soreness of the affected parts seems to be the special sphere of remedy. There are passive hemorrhages from any part.
Worse from-warm and moist air.
Dosage: Take in 200 potencies. 3 pellets 3 times a day with less frequency as improvement is made.
Phosphorus
There is bleeding from the nose while straining at a stool early in the morning, It is seen in tall, slim girls at the age of puberty. Severe epistaxis is seen in cases of diphtheria. There is profuse bleeding from the nose, often accompanied by profuse sweat. There is bloody streaks in the nasal mucus.
Worse from touch, any physical or mental exertion, warm food or drink, change of weather, from getting.
Better from- In the dark, lying on the right side, cold food.
Dosage: Take in 200 potencies. 3 pellets 3 times a day with less frequency as improvement is made.