Nose bleeding seems to be one of the most common infections. However, it can be a sign of a major underlying health condition. In an interview with HT Lifestyle, Dr Sumit Mrig, director and unit head, ENT(Ear, Nose, Throat), Audiology, Max Smart Hospital, Saket, decodes the common triggers and serious warning signs.
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Why nose bleeding happens in children?
Dr Sumit emphasised that most commonly we see nosebleeds happening in small children, especially when they have a tendency to pick their nose, where the anterior part of the septum and the vestibule area, where it is the plexus area, which forms a lot of involvement of the blood vessels, and because of irritation the bleed can happen.
“In children who have underlying thalassemia conditions, sickle cell conditions, or hematogenous conditions where the blood clotting is affected, babies born with underlying congenital disorders of the bleeding pathway can experience excessive amounts of nosebleeds,” said Dr Sumit.
And if such incidents happen, then it is important to investigate the underlying condition. Otherwise, in most cases, just avoid nose picking and lubricating that area. Dr Sumit advises seeing an ENT surgeon, and in the worst of scenarios, the child may need cauterization of the blood vessels in the anterior area, which is called the Kayselbach plexus.
Why nose bleeding happens in adults?
According to Dr Sumit, what we see in adulthood and old age, especially with epistaxis. This epistaxis can range from a few drops of blood to profuse epistaxis, where it flows like water from the tap. And this can, because of underlying conditions, especially in old age, be uncontrolled hypertension.
“When there is a fluctuation of the blood vessels, the capillaries in the nose are the commonest and the easiest ones to rupture,” said Sumit. The difficulty is that in old age, the Woodruff’s plexus, the plexus which is present in the posterior end of the nasal septum, bleeds, and it is difficult to control that bleed, and this may sometimes need admission, and the bleeding needs to be controlled in the operation theater.
Is your nose bleed just seasonal or a sign of something serious?
“Bleeding from the nose can be a sign of underlying hematological conditions, but most importantly, liver disorders,” said Dr Sumit. People with chronic liver failures, such as alcoholic liver cirrhosis, in which the formation of coagulation factors is affected, will experience bleeding.
Many patients who are in end-stage renal failure or end-stage liver failure do come with episodes of epistaxis, and the cause is mainly a defect of production of these coagulation factors— Factor V, Leiden factor— in the blood, which causes profuse epistaxis.
Dr Sumit further explained that patients who have undergone the procedures for blocked cardiac arteries, where angiography and angioplasty or coronary artery bypass grafting are involved, are put on anticoagulants like warfarin, clopidogrel, ecosprin, aspirin, and other medications that can dilute the blood to an extent where even with a minor rise in blood pressure, bleeding can happen from the nose.
Note to readers: This article is for informational purposes only and not a substitute for professional medical advice. Always seek the advice of your doctor with any questions about a medical condition.
