Chronic nosebleeds

Nosebleeds are one of the most common everyday ailments in our society. Often a vigorous blowing of the nose or a light blow is enough to burst the fine blood vessels of the human nasal mucosa. In some cases this occurs more and more and for no apparent cause, so that one chronic nosebleeds can be spoken.

What is chronic nosebleed?

Chronic nosebleed, which is called epistaxis in medical jargon, can occur as a symptomatic consequence of various underlying diseases and thus due to a wide variety of factors and with varying frequency and intensity. The human nasal mucosa is extremely well supplied with blood and is traversed by the finest capillary systems, which can burst due to various factors and cause more or less massive bleeding in the nose.

In the case of sensitive mucous membranes, light shaking or blowing your nose is often enough to trigger this type of bleeding sporadically. If it is a chronic nosebleed, this usually occurs suddenly and for no directly recognizable reason, but with recurring regularity. In this case, the underlying cause should be clarified by a doctor.

causes

As a rule, a chronic variant of nosebleed is the result of another disease. In many cases, there is a vascular disease or a disorder of blood clotting, which in turn can be caused by metabolic diseases or by long-term use of various drugs.

Similar to impaired blood clotting, high blood pressure can also be a possible cause of chronic nosebleeds. Often, however, there is also a local underlying disease: Any disturbances in the nasopharynx as a result of a cold can cause the nasal mucosa to swell and thus indirectly trigger chronic bleeding in the nose. Pollen or animal hair allergies also promote excessive swelling of the nasal mucous membrane and can therefore be the cause of recurrent bleeding.

Benign or malignant nasal tumors are also possible causes of chronic nosebleeds: If the growths in the interior of the nose grow excessively, they can permanently injure the mucous membrane and encourage heavy bleeding. Congenital or accidental malformations of the nasal septum often trigger chronic bleeding in the nose; protruding spurs or cartilage can severely injure the mucous membrane and thus irreparably damage it.

Another factor that is often responsible for chronic nosebleeds is the consumption of certain drugs or contact with aggressive chemicals, which usually cause cracks and holes in the sensitive nasal mucosa.

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Diseases with this symptom

• Blood clotting disorder
• cold
• Polyps

• Metabolic disorder
• hay fever
• Drug addiction

• high blood pressure
• Pet hair allergy
• Drug allergy

Diagnosis & course of disease

Regular chronic nosebleeds can easily be diagnosed based on the clear symptoms. In order to initiate appropriate therapy, the attending physician therefore first determines the underlying disease that is causing the bleeding. By determining the blood values ​​and with the aid of medical procedures such as MRI and CT, the body's own cause can be precisely determined.

Another crucial point for making a diagnosis are the accompanying symptoms, which occur in combination with the nosebleed and can provide significant information about the respective underlying disease. Those affected often complain of toothache and pain in the inner and outer area of ​​the nose. If a purulent discharge occurs from the nose, this can be the first sign of a nasal tumor. Often there is also a strong feeling of exhaustion and an increased feeling of weakness.

If the chronic nosebleed is accompanied by other bleeding in atypical parts of the body, this can indicate a bleeding disorder. If an additional fever occurs, the suspicion of another chronic infection is reinforced.

Complications

Chronic nosebleeds involve various risks due to the loss of blood on the one hand and damage to the mucous membrane on the other. With severe nosebleeds, for example, there is a risk of circulatory collapse and permanent consequential damage due to the anemia that occurs. There is also the risk that blood will penetrate the windpipe and cause shortness of breath and even vomiting.

With arterial nosebleeds, the rapid loss of blood can lead to the patient bleeding to death. Symptoms such as fatigue and tiredness that occur as a result of blood loss are less severe. The first signs are pale skin and tremors, with the symptoms constantly increasing and, if left untreated, can also lead to circulatory collapse. In addition, chronic nosebleeds cause the body to lack vitamin B12, iron, and other minerals, which can lead to a variety of other complications. Typical is pernicious anemia, which occurs as a result of a vitamin B12 deficiency and leads to changes in the mucous membrane, burning tongue and other complaints.

The cooling compresses and speed handkerchiefs often used in chronic nosebleeds favor complications such as hypoxia or sinusitis. In general, nasally inserted cloths or bandages favor circulatory disorders of the mucous membrane and can thus trigger a toxic shock syndrome in extreme cases. Unsuitable treatment measures, such as tilting your head back and letting the blood run back into your nose, can in turn lead to further symptoms.

When should you go to the doctor?

If nosebleeds have no clearly identifiable cause, such as the mechanical impact of a blow or extremely violent rubbing when blowing your nose and if it occurs several times for no reason, it is called chronic nosebleeds. The chronic nosebleed that comes out of the blue is not just annoying. Chronic nosebleeds can have an illness-related cause and should therefore always be clarified by a doctor.

In addition to increased blood pressure, chronic nosebleeds can be due to a blood vessel disease or blood clotting disorder. It can also be triggered by some metabolic diseases or drugs that have been taken. In the case of a severe cold with impairments in the nasopharynx, there is justified suspicion of the connection between the nosebleed and the swollen and irritated nasal mucosa.

Allergies to pollen or animal hair can have a similar effect. Of course, in the case of chronic nosebleeds, growth in the nose, deformities and tumors must be considered. The attending physician should also ask his patient about - mostly professional - handling of aggressive chemicals and any drug use.

For the treatment of chronic nosebleeds, in addition to the general practitioner, an internist, ear, nose and throat specialist, allergist or surgeon can be considered. In the event of an unusually violent chronic nosebleed with high blood loss, an emergency doctor should be called as a precaution.

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Treatment & Therapy

Similar to the diagnosis, the therapies and treatment options in question also depend on the respective causal disease. If there is only a chronically swelling nasal mucous membrane, this can be treated with special sprays that mainly contain decongestant agents. If the underlying cause is a bacterial infection, the patient can be effectively treated with an antibiotic.

The medical procedure for coagulation disorders and high blood pressure is similar: Here, drug therapies are used to heal the person affected. In many cases, the cause of chronic nosebleeds can also be surgically eliminated. If the nasal septum is curved or deformed, protruding cartilage and spurs can be completely removed by means of an operation.

Malignant nasal tumors are treated similarly; In the case of benign tumors, surgical removal is only possible if these obstruct breathing. With this and related treatment methods, chronic nosebleeds can usually be treated before they cause serious health consequences for the person concerned. If left untreated, the high blood loss in the patient can lead to serious secondary diseases; circulatory problems and even fainting spells often occur.

Outlook & forecast

As a rule, nosebleeds in the front area of ​​the nose are not dangerous. The bleeding can be stopped quickly with specific measures. If there is an allergic cause such as hay fever, the treatment can last for years. If the bleeding persists for a longer period of time despite the measures taken, the bleeding can be inhibited by obliterating the injured blood vessel or nasal packing.

The nosebleed in the back of the nose is harder to locate and control. This can be remedied by a clip or an operation. These methods will prevent further bleeding from the nose.

However, if there is a serious internal illness, the bleeding may return. It is important to have an early diagnosis made by an ENT doctor, which can significantly influence the chance of a cure. Especially when the supposed nosebleed is not caused by the nose at all but by other parts of the body, such as esophageal varices.

If the nosebleed remains untreated for a long time, especially if the amount of blood increases considerably, there is a risk of circulatory weakness or anemia (anemia). This can be life threatening. Initiating an infusion or blood transfusion quickly can prevent serious consequences.

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prevention

However, a chronic nosebleed can usually be effectively averted in advance through various preventive measures. People who have a tendency to dry nasal mucous membranes should pay attention to a suitably humid room climate and adequate ventilation, especially at work and in the bedroom. In addition, nasal showers are an additional way of moistening the mucous membranes and thus stimulating regeneration, which is particularly recommended during the heating season in the cold season.

As an alternative to this, pharmacies offer a wide range of over-the-counter sprays and ointments that have a similar nourishing effect on the mucous membranes. An appropriate lifestyle, sufficient physical activity and a balanced diet are also essential for the health of the nasal mucous membranes.

You can do that yourself

Various measures relieve chronic nosebleeds. Sufficiently moist room air is helpful. For example, a damp cloth can be hung over the heater or an indoor fountain can be set up.

A nasal douche, nourishing sprays, nasal ointments or nasal oils are recommended. Inhalations using saline solutions are also useful. In this way, the sensitive nasal mucosa is cared for and kept supple. Encrustations in the nose, caused by a cold or previous nosebleed, are gently dissolved. The nose doesn't start bleeding again. For treatment in acute cases, there are also special nose pins that soothe the mucous membrane of the nose and close small wounds.

If blood comes from the nose, those affected should sit down bent over and let the blood drain off. You should then gently squeeze your nose for at least ten minutes while breathing through your mouth. Cold compresses that are placed on the neck are also useful. They narrow the blood vessels and help stop bleeding. In addition, tamponade can stop further blood loss. Chronic nostrils or violent blowing of the nose should be avoided.

It is important to drink enough fluids (at least 1.5 to 2 liters per day). This ensures that the mucous membranes are moistened. A healthy diet is also essential for chronic nosebleeds. For example, vitamin C strengthens the small blood vessels in the nasal mucosa.