Nosebleed

Image:BrokenNose.jpg

A nosebleed or nose bleed, medically known as epistaxis, is the relatively common occurrence of hemorrhage(bleeding) from the nose, usually noticed when it drains out through the nostrils. There are two types: anterior (the most common), and posterior (less common, and more severe). Sometimes in more severe cases, the blood can come up the sinus and out from the eye. Fresh blood and clotted blood can also flow down into the stomach and cause upset stomachs and vomiting.

Causes

There are several causes for the nosebleed including trauma(such as hitting the nose), fracture(broken nose), pressure(such as may be caused by altitude), anticoagulant(anti-clotting) medication, excessively dry air, excessive nose-picking, allergic rhinitisand high blood pressureamong the elderly. Some rare diseases that may cause nosebleeds are Wegener's granulomatosisand hereditary hemorrhagic telangiectasia(HHT, Rendu-Osler-Weber disease); sarcoidosis, when it involves the nose, has been reported to cause nosebleeds. von Willebrand diseasemay cause nosebleeds.

Both the frequency of spontaneous epistaxis and the length and severity of bleeding can be increased by anticoagulants. These may include prescription medications such as warfarinor aspirinas well as herbal supplements such as ginkgo. Cultures with a diet rich in fish sources that include high levels of omega-3 fatty acids(especially the Inuit) have also been observed to experience a higher incidence of nosebleeds. Athletes and bodybuilers who supplement their diets with fish oil also report increased frequency of nosebleeds.

Pathophysiology

All nosebleeds are due to tears in the mucosal lining and the many small blood vessels it contains. Fragility or injury may cause the tears, while inflammation, coagulation problems and other disorders may make the injury harder to repair.

Treatment

The flow of blood normally stops when the blood clots, which may be encouraged by direct pressure. Medical opinion is divided on whether the best position to apply pressure is the bridge of the nose or the fleshy part. It is also undecided as to whether it is better to tilt the headforward during this procedure (to drain the blood and prevent it from flowing down the throatand into the stomach) or backward (to minimize the volume of blood in the nose). Petroleum jellyis often used to stop the blood from seeping out.

Chronic epistaxis resulting from a dry nasal mucosa is often treated by spraying salinein the nose up to three times per day.

If techniques such as pressure, ice on the bridge of the nose, application of a vasoconstrictor, etc. don't work, a nasal tamponis usually the next step. The nasal tampon stops the bleeding by applying pressure from inside of the nose and is usually kept in for 1-3 days.

Persistent epistaxis is an indication for urgent medical consultation. Nasal packing, cryosurgery, electrocauteryor application of trichloracetic acidare options that may be used in severe epistaxis.

It is uncommon to exsanguinate (die from bleeding) through nosebleeds. However, damage to the maxillary artery can lead to rapid blood loss via the nose and present difficulty in treatment, pressure, vasoconstrictor and rhinocort occasionally proving ineffective. Ligation of the artery, risking damage to the facial nerves, may be the only solution.

Nevertheless, severe protracted nosebleeds may cause anemiadue to iron deficiency.

Famous nosebleeds

Attila the Hun, a legendary commander and the founder of an empire, is reputed by the contemporary historian Priscusto have died of a nosebleed after his wedding.

Nosebleeds in fiction

In animeand manga, it is very common to see sexually aroused characters getting nosebleeds, sometimes brutal ones. This rarely occurs in real life, but is based on Japaneseold wives' tales, which say that getting too sexually excited leads to a nosebleed. Such occurrences are generally played for laughs and signify loserhoodand/or virginity.de:Epistaxis fr:Épistaxis it:Epistassi ja:鼻血 pt:Epistaxis sv:Näsblod

This article is licensed under the GNU Free Documentation License.
It uses material from the http://en.wikipedia.org/wiki/Nosebleed Wikipedia article Nosebleed.