nosebleeds

Nosebleeds, or epistaxis, are bleeding from the nasal mucosa. They are a common condition encountered in primary care. Most episodes are mild, short in duration, and originate in the anterior nasal septum.

The anterior bleeds usually arise from Kiesselbach's plexus, a network of vessels at the front of the nose. Posterior bleeds, less common, involve deeper arteries and can be more severe. Risk factors include dry air, nasal trauma or irritation, infections, allergies, and medications such as anticoagulants or antiplatelets.

Symptoms include visible blood from the nostrils and sometimes blood swallowed or in the throat. Seek medical care for heavy bleeding, bleeding lasting more than 20 minutes, recurrent episodes, head injury, fainting, or underlying conditions such as a known bleeding disorder or use of blood thinners.

First aid: sit up, lean forward slightly, and pinch the soft part of the nose for 5–10 minutes while breathing through the mouth. Do not tilt the head back. After bleeding stops, avoid nose blowing or picking for 24 hours and keep the nasal passages moist with saline spray or a humidifier.

Medical treatment may include cauterization of the bleeding site or nasal packing for recurrent or persistent bleeds. Posterior bleeds or symptoms suggesting an underlying condition require evaluation by an ear, nose, and throat specialist and possible investigation for clotting disorders or medication-related causes.