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What should be done in case of bleeding from the nose?

Bleeding from the nose is a problem that can cause fear. In fact, most bleeding from the nose is not as serious a problem as it might seem.

However, caution should be taken because a proportion of these cases are related to more serious illnesses and so required vigilance to identify the cause of the problem.

If someone is bleeding from the nose or ‘epitaxis’ as is medically termed, they should sit down and lean the head slightly forward.

The head should be kept at a level higher than the heart, because it will bleed less. The slight inclination of the head towards the front, allows blood to be discharged out of the nostrils and not back to the pharynx.

The head should not be tilted backward as the blood then goes back down the pharynx and the patient swallows. This can causes nausea, vomiting and diarrhea.

To assist the bleeding to stop, the patient can pinch lightly between thumb and forefinger, the area of ​​the nose that is between the hard part of the nose (nasal bone) and soft part below.

For best results, tightness should be maintained for at least 5-10 minutes. Usually after 10 minutes, ‘epistaxis’ stops. If it continues, then hold again for another 10 minutes.

Also the positioning of cold ice in the same area of ​​the nose helps to stop bleeding.

What causes bleeding from the nose?

The nose has many blood vessels which help to heat and moisten the air we breathe. Because they are closer to the surface of the nasal mucosa is more vulnerable to injury and cause bleeding.

The most common cause of bleeding from the nose is sore inside of nose.

In areas without heating and dehumidified air, the mucosa of the nose can become dry and cause bleeding.

Scratching the nose with fingers, especially nails can cause bleeding. In the front part of the nose, particularly the diaphragm, there are many vessels.

Most cases of bleeding occur in children due to dryness of the internal mucosa of the nose, in rhinitis and scratching of the nose with the fingers.

In children a foreign body inserted into the nose of the nostrils as well as various injuries, can cause bleeding.

In adults, injuries, infections of the nose, allergies, high blood pressure, arteriosclerosis, bleeding diathesis, anticoagulant medications, aspirin, drought and low humidity are causes of epistaxis.

When the patient must visit the doctor?

In some cases, such as those mentioned below, it may be necessary for the patient to visit the doctor:

  • When bleeding lasts for more than 15 minutes
  • When bleeding is caused by an injury (blow to the face), after a car accident or after a fall.
  • Where the nose bleeds often
  • In the case of bleeding from the rear part of the nose. These cases are rare and usually occur in the elderly, the bleeding is from large vessels of the posterior part of the nose. These hemorrhages are serious and need medical treatment necessary.

In the elderly, high blood pressure, atherosclerosis, bleeding is likely either due to disease or medication such as aspirin, and can cause severe posterior nosebleeds. The doctor will clarify whether it is anterior or posterior bleeding. We also investigate whether there is another disease or generalized or local body responsible for causing the bleeding.

The specialist doctor, otolaryngologist, can use various methods to stop the bleeding, which include suction cleaning, the fitting of cotton impregnated with vasoconstrictive substance, the cauterization of bleeding vessels, tamponade (patted). Rarely, you may need surgery to stop nosebleeds.

Antihistamine – Decongestant and Relief medication for common colds

Drugs for stuffy nose and sinus problems, nasal congestion and common cold constitute the largest segment of the pharmaceutical industry. When used properly, these drugs provide relief from annoying symptoms which occur in almost all people at some time and in some chronically. Drugs in these categories are useful for relieving allergy symptoms, inflammation of upper respiratory infections such as sinusitis, common cold, flu and vasomotor rhinitis. These drugs do not cure allergies, infections, etc. but relieve the symptoms so that the patient feels more comfortable.

Antihistamines

Histamine is a chemical agent which can cause allergies or inflammation conditions such as congestion, sneezing and runny nose. Antihistamine drugs block the action of histamine and therefore reduce the allergic symptoms. For best results they should be taken before allergic symptoms occur. The most common side effect is drowsiness. This is not a problem when taken at bedtime, but patients who need to use them daily can suffer drowsiness with all its’ consequences. It is not recommended for people who drive a car or operate hazardous machinery.

Decongestants

Congestion in the nose and sinuses is due to the swelling and expansion of blood vessels in the mucosa of the nose and airway. The mucosa of the nose has an abundance of high-capacity vessels on stretching. Histamine stimulates the dilation of these blood vessels causing them to swell. Decongestants cause vasoconstriction which assists the blood to leave the mucosa and vessels to shrink therefore allowing air to pass more easily. Decongestant substances are chemically related to adrenaline, a natural vasoconstrictor that is a kind of divider. So the side effect is restlessness (jittery). They can create difficulty sleeping and increased blood pressure and pulse frequency. They should not be used by people with hypertension, arrhythmia or heart disease, and in patients suffering from glaucoma.

COMBINATION

Theoretically to balance the side effects of drowsiness, antihistamines may be neutralized by the stimulation of decongestants. Possibly using various combinations. A patient may use several formulations for several months or years. After a time it may be necessary to change to another formulation when the first has lost its activity. No-one reacts the same as someone else; your doctor should regulate the right balance of dose. For example you may take only the antihistamine night and only decongestant by day. Or you can take an increasing dose of antihistamine at night and reduce the dose of decongestant. The opposite might work in the day.

RELIEVER SYMPTOMS EFFECTS
Antihistamines

Sneezing

Catarrh

Stuffy nose

Itchy eyes

Hyperemia

Drowsiness

Dry mouth and runny nose

Decongestants

Blocked nose

Hyperemia

Stimulation

Increased heart rate

Insomnia

COMBINATION All the above Any of the above

Relief medication for common colds

These mainly contain antihistamines and decongestants, and other ingredients such as cough suppressants. The doctor must choose the components that fit the patient’s symptoms to help him.

Nasal Spray

These types of nasal spray usually contain decongestants for direct spray to the nasal mucosa. These can provide immediate relief from congestion due to constriction of blood vessels. The direct application creates a much stronger stimulation of the corresponding oral and impairs the blood circulation of the nose which after a few hours causes irritating vessels to dilate and increase the air supply again. This results in a reaction (rebound or bounce-back effect). The congestion returns. The patient feels the need to use the spray again and as it does, restarts the cycle spray – congestion – congestion reaction again, again spray. In babies this rhinitis can be installed within 2 days. In babies the treatment is deliberate interrupting the spray for 12-24h but adult cases may require oral decongestants, corticosteroids and sometimes can (after use for months or years continuously) even surgery. For this reason, do not use decongestant spray for longer than 7 days. The above description does not include the type of anti-allergy spray prescribed by your doctor for treatment of allergies.

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