Why you should take nose bleeding seriously
Feb 10, 2008
ESTHER Asiimwe aged 15, recently got the shock of her life when blood started oozing from her nose spontaneously as she bent to wash her clothes. Nose bleeding affects both the old and the young alike.
By Agnes Kyotalengerire
ESTHER Asiimwe aged 15, recently got the shock of her life when blood started oozing from her nose spontaneously as she bent to wash her clothes. Nose bleeding affects both the old and the young alike.
It occurs either from the anterior (front) or posterior (behind) of the nose.
Dr Arnold Nkalubo Nambassi, a specialist in Ear Nose and Throat (ENT) with Africa Ambulance Rescue says: “Although nose bleeding is a common thing and is often taken lightly, it is worth worrying about.â€
According to Dr Micheal Awubwa, a specialist with the ENT Department Makerere Medical School, anterior bleeding is common in children or young people between the age of 15 to 25.
Awubwa says 90% of anterior bleeding begins from the lytle’s area (where vessels that supply the nose meet). Posterior nasal bleeding is more common among 45 to 65-year-olds.
He explains that elderly people who have high blood pressure or arteriosclerosis experience more severe bleeding.
Arteriosclerosis is a disease where the arteries thicken and cholesterol gets deposited on the inner lining of arteries, making them inelastic.
Awubwa says nasal bleeding is higher during colder months when acute infections like sinusitis that affect the nose, nasal cavity, trachea or larynx are more frequent.
It is also common in areas with low humidity because the delicate skin lining the inside of the nose (mucus membrane) dries, causing the vessels in the nose to burst.
What causes nose bleeding?
Dr Edison Babigamba, an ENT specialist at the ENT Department of Makerere Medical School, says: “The nose has many small delicate veins on the mucus membrane. For various reasons, the delicate blood vessels break, causing bleeding.â€
Patients who suffer from rhinosinusitis are prone to nose bleeding because the nasal mucosa is more susceptible to sores and can easily break. Rhinosinusitis is a disease that causes the mucus membrane to swell in the nose (usually called sinusitis).
Babigamba adds that the inside of the nose has swellings of different patterns and sizes, commonly known as the normal nasal cycle. When the nerves in the nose detect change in the weather, the vessels become thin and burst.
Nkalubo says nose bleeding occurs due to local or general causes. Local causes occur when something goes wrong in the nose, while general ones occur when something goes wrong in the mechanisms which stop bleeding.
Among the local causes, there may be conditions that are born with the problem or acquired. In this case, infections in the nose such as colds, can cause nose bleeding.
He adds that chronic diseases like TB can infect the skin in the nose, causing bleeding. Trauma or injuries and foreign bodies in the nose are also a common cause of nose bleeding.
Picking and blowing the nose injures the nasal vessels. Inflammatory conditions which include allergy, overgrowth of the lining of sinuses and nasal cancers also cause bleeding.
Nkalubo explains that HIV/AIDS accounts for almost 14% of nasal bleeding because some patients have a low platelet acount, which is responsible for stopping bleeding.
However, he says there are other causes of nasal bleeding like blood vessel disorders (abnormal walls of the blood vessels) and bleeding disorders which disrupt mechanisms that stop bleeding.
Consuming alcohol, aspirin and anti-cancer drugs also causes nose bleeding.
Nkalubo says kidney and liver diseases tend to cause bleeding because these organs manufacture organisms that stop bleeding.
First aid
Nkalubo emphasises that bleeding should be taken seriously and the cause of the bleeding diagnosed. However, he advises that first aid should be done.
Ask the patient to press the nasal passages together for about 10-20 minute intervals to check whether the bleeding has stopped. While holding the nose, the patient can open the mouth and breathe through it to avoid getting blood clots into the air passages.
Make the patient lean forward or sit up. By sitting up, the area that is bleeding is elevated above the heart and in doing so, blood flow is reduced.
In case blood escapes through the back, ask the patient to spit it to avoid stomach upset and vomiting.
Refrain from any movement for some time. If bleeding continues after 20 minutes of direct pressure, rush the patient to the nearest clinic.
The health worker will pack cotton wool, rolled tissue smeared with tetracycline eye ointment or gauze with Vaseline in the nasal passages to arrest the bleeding.
The ointment works as an anti-biotic and the Vaseline lubricates the nasal passages to avoid cracking, while pulling out the cotton wool.
Nkalubo explains that first aid calms bleeding and anxiety, but does not solve the problem.
Therefore, it is advisable to take the patient to an ENT specialist to examine and investigate the cause of the bleeding.
Prevention
Avoid picking the nose.
Avoid applying medication in the nose without a doctor’s prescription.
Eat plenty of vegetables and fruits with vitamin C. l Seek medical advise on nasal diseases like allergy.
Drink plenty of water to keep the nose moist.
Remedy
Herbal: David Ssali, a naturopathic (specialist in alternative medicine), says the woundwort herb helps combat bleeding. The leaves should be pounded into powder and sniffed.
They help in blood clotting and relieving pain. People suffering from nose bleeding should eat green leafy vegetables daily because they are high in vitamin K.
Vitamin K is responsible for making prothrombin (a factor in blood that causes clotting). Without the vitamin prothrombin levels become low causing bleeding problems.
Alternatively, a patient should take two-three teaspoons of chlorophyll juice prepared from the green vegetables daily, in order get vitamin K.
ESTHER Asiimwe aged 15, recently got the shock of her life when blood started oozing from her nose spontaneously as she bent to wash her clothes. Nose bleeding affects both the old and the young alike.
It occurs either from the anterior (front) or posterior (behind) of the nose.
Dr Arnold Nkalubo Nambassi, a specialist in Ear Nose and Throat (ENT) with Africa Ambulance Rescue says: “Although nose bleeding is a common thing and is often taken lightly, it is worth worrying about.â€
According to Dr Micheal Awubwa, a specialist with the ENT Department Makerere Medical School, anterior bleeding is common in children or young people between the age of 15 to 25.
Awubwa says 90% of anterior bleeding begins from the lytle’s area (where vessels that supply the nose meet). Posterior nasal bleeding is more common among 45 to 65-year-olds.
He explains that elderly people who have high blood pressure or arteriosclerosis experience more severe bleeding.
Arteriosclerosis is a disease where the arteries thicken and cholesterol gets deposited on the inner lining of arteries, making them inelastic.
Awubwa says nasal bleeding is higher during colder months when acute infections like sinusitis that affect the nose, nasal cavity, trachea or larynx are more frequent.
It is also common in areas with low humidity because the delicate skin lining the inside of the nose (mucus membrane) dries, causing the vessels in the nose to burst.
What causes nose bleeding?
Dr Edison Babigamba, an ENT specialist at the ENT Department of Makerere Medical School, says: “The nose has many small delicate veins on the mucus membrane. For various reasons, the delicate blood vessels break, causing bleeding.â€
Patients who suffer from rhinosinusitis are prone to nose bleeding because the nasal mucosa is more susceptible to sores and can easily break. Rhinosinusitis is a disease that causes the mucus membrane to swell in the nose (usually called sinusitis).
Babigamba adds that the inside of the nose has swellings of different patterns and sizes, commonly known as the normal nasal cycle. When the nerves in the nose detect change in the weather, the vessels become thin and burst.
Nkalubo says nose bleeding occurs due to local or general causes. Local causes occur when something goes wrong in the nose, while general ones occur when something goes wrong in the mechanisms which stop bleeding.
Among the local causes, there may be conditions that are born with the problem or acquired. In this case, infections in the nose such as colds, can cause nose bleeding.
He adds that chronic diseases like TB can infect the skin in the nose, causing bleeding. Trauma or injuries and foreign bodies in the nose are also a common cause of nose bleeding.
Picking and blowing the nose injures the nasal vessels. Inflammatory conditions which include allergy, overgrowth of the lining of sinuses and nasal cancers also cause bleeding.
Nkalubo explains that HIV/AIDS accounts for almost 14% of nasal bleeding because some patients have a low platelet acount, which is responsible for stopping bleeding.
However, he says there are other causes of nasal bleeding like blood vessel disorders (abnormal walls of the blood vessels) and bleeding disorders which disrupt mechanisms that stop bleeding.
Consuming alcohol, aspirin and anti-cancer drugs also causes nose bleeding.
Nkalubo says kidney and liver diseases tend to cause bleeding because these organs manufacture organisms that stop bleeding.
First aid
Nkalubo emphasises that bleeding should be taken seriously and the cause of the bleeding diagnosed. However, he advises that first aid should be done.
Ask the patient to press the nasal passages together for about 10-20 minute intervals to check whether the bleeding has stopped. While holding the nose, the patient can open the mouth and breathe through it to avoid getting blood clots into the air passages.
Make the patient lean forward or sit up. By sitting up, the area that is bleeding is elevated above the heart and in doing so, blood flow is reduced.
In case blood escapes through the back, ask the patient to spit it to avoid stomach upset and vomiting.
Refrain from any movement for some time. If bleeding continues after 20 minutes of direct pressure, rush the patient to the nearest clinic.
The health worker will pack cotton wool, rolled tissue smeared with tetracycline eye ointment or gauze with Vaseline in the nasal passages to arrest the bleeding.
The ointment works as an anti-biotic and the Vaseline lubricates the nasal passages to avoid cracking, while pulling out the cotton wool.
Nkalubo explains that first aid calms bleeding and anxiety, but does not solve the problem.
Therefore, it is advisable to take the patient to an ENT specialist to examine and investigate the cause of the bleeding.
Prevention
Avoid picking the nose.
Avoid applying medication in the nose without a doctor’s prescription.
Eat plenty of vegetables and fruits with vitamin C. l Seek medical advise on nasal diseases like allergy.
Drink plenty of water to keep the nose moist.
Remedy
Herbal: David Ssali, a naturopathic (specialist in alternative medicine), says the woundwort herb helps combat bleeding. The leaves should be pounded into powder and sniffed.
They help in blood clotting and relieving pain. People suffering from nose bleeding should eat green leafy vegetables daily because they are high in vitamin K.
Vitamin K is responsible for making prothrombin (a factor in blood that causes clotting). Without the vitamin prothrombin levels become low causing bleeding problems.
Alternatively, a patient should take two-three teaspoons of chlorophyll juice prepared from the green vegetables daily, in order get vitamin K.