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Causes of black blood from nose. Blood from the nose: causes of occurrence in an adult

Sudden bleeding is always frightening or at least alarming for the reason that ideally the blood should be inside the vessels, and not come out of them to the surface. Blood from the nose always causes the same concern - its causes can lie in two different planes - local problems and general diseases.

Types of nosebleeds

The nose is an olfactory organ, richly innervated and equipped a huge amount vessels. Injured or weak vessels sometimes leak, which is characterized by varying degrees of intensity: in some cases only a few drops leak out, in others moderate or heavy (profuse) bleeding develops.

Nosebleeds are distinguished by the following symptoms:

Localizations;
Frequency of occurrence;
The mechanism and type of damaged vessels;
Volume of blood loss.

The totality of data obtained by the doctor during the examination (examination) of the patient allows one to determine the nature of the bleeding, its causes, as well as assess possible risks and provide first aid. If necessary, further treatment is prescribed.

Localization of nosebleeds

Most often, bleeding occurs from the Kisselbach area - a plexus of blood vessels in the anterior part of the nasal septum. They are harmless and can be easily stopped even by a non-specialist - you just need to know how to stop a nosebleed without the intervention of a medical professional.

Even more often, anterior nosebleeds stop on their own - especially if their volume does not exceed a few drops.

The situation is more complicated and more dangerous with bleeding from the back of the nose: the volume of blood is usually significant. The danger is that outwardly the situation may look like a slight blood loss, since the main volume of blood does not flow out - it ends up in the throat, so the person is forced to swallow it all.

Swallowed blood causes nausea and bloody vomiting: vomit may be scarlet (when fresh blood enters the stomach) or brown (when the blood has already coagulated). You cannot do without medical help here.

Frequency of occurrence

Nosebleeds can be infrequent or recurrent. Rare bleeding that ends quickly and spontaneously does not cause any concern - they are considered a minor nuisance, nothing more. This is indeed true: a small vessel bursting while blowing your nose is unlikely to seriously undermine your health.

Recurrent nosebleeds are a clear reason to be wary and undergo an examination to find out why your nose began to bleed. If blood flows from the nose frequently, this may be a symptom of some disease or passing condition.

Mechanism

There are spontaneous and traumatic mechanisms of nosebleeds. Spontaneously occurring bleeding occurs as if by itself, and traumatic bleeding occurs as a result of injury to the nose with a blow or surgical intervention (for example, removal of the adenoids).

Blood flows from damaged vessels - arteries, veins or capillaries. The slightest bleeding occurs when small vessels - capillaries - are damaged, the most intense - when arteries are damaged.

Volume of blood loss

The volume of blood leaking from the nose can range from several milliliters to half a liter.

Blood loss of a few milliliters is considered insignificant;
Blood loss is assessed as moderate if its volume does not exceed 200 ml;
About massive blood loss we're talking about in cases where up to 300 ml of blood flows out in total or simultaneously;
Profuse bleeding is characterized by a large volume - 500 ml and above.

Minor blood loss does not require specialist intervention; in all other cases, you should immediately call a doctor or an ambulance team.

Serious causes of nosebleeds

If you or someone nearby has a nosebleed, the reasons must be clarified quickly and accurately, since further tactics of behavior will depend on this.

This can be self-help or calling specialists for further examination and treatment.

Traumatic nosebleeds are always understandable because they begin immediately after a bruise or blow. Everything is clear with postoperative bleeding - here you can never do without blood.

But what to do if there were no injuries, no surgery on the nose, but the blood flows, and flows often and for no apparent reason?

Causes of nosebleeds may be associated with the following conditions:

Vascular diseases;
Diseases of the blood, hematopoietic organs;
Infections;
Neoplasms in the nasal cavity;
Vitamin deficiencies.

With vascular diseases, their walls quickly wear out, becoming brittle and permeable, which is why hypertensive crises are often accompanied by nosebleeds.

By nature, weak capillaries rupture every time, and the nose begins to bleed when blowing the nose or sneezing.

Blood diseases (Werlhof's disease, hemophilia, chlorosis, leukemia, some types of anemia) also cause frequent and sometimes heavy nosebleeds, which can be difficult to stop without medical intervention.

With hepatitis and cirrhosis, a blood clotting disorder occurs. One of the manifestations of these severe liver lesions is nosebleeds.

Viral and bacterial infections, which people so often get sick in the off-season, cause swelling of the nasal mucosa and irritation of blood vessels, so when you blow your nose and sneeze, a little blood may come out. Such minor bleeding goes away on its own when the sick person recovers.

An exacerbation of any form of sinusitis can also cause nosebleeds - especially when trying to blow your nose.

Polyps, angiomas, papillomas and adenoids- benign tumors in the nose, which often cause sudden bleeding, since the tumors are equipped with vessels that are also susceptible to rupture when blowing the nose, snoring or sneezing.

Vitamin deficiency, caused by a deficiency of vitamins C and B3, affects blood clotting. If you experience nosebleeds, you should pay attention to how you eat.

Each of the above conditions can cause nosebleeds at any time of the day - even at night, so a morning spot of blood on the pillow has the same explanation as afternoon or evening bleeding.

When not to worry

Nosebleeds occur during pregnancy or other periods of body change when significant shifts in hormonal balance occur. With the stabilization of hormonal levels, nosebleeds stop.

A trip to the bathhouse, a long flight, or climbing high in the mountains cause sharp fluctuations in blood pressure, so slight bleeding is normal and there is no need to worry.

First aid for nosebleeds

You need to stop a nosebleed - how to do it correctly so as not to worsen the condition?

Here are some mandatory measures:

Sit the person down, tilt his head forward so that the blood drains from the wings of his nose;
If the patient is lying down, you need to turn him on his side so that the flowing blood does not accidentally enter his nasopharynx;
Place a cold object on the bridge of your nose (ice, a piece of frozen meat, plastic bottle With cold water) - this will help achieve rapid vasoconstriction;
If the measures described are not enough, try pressing your nostril to the nasal septum - a blood clot will quickly form in the damaged vessel, which will close the breakthrough;
Use a swab soaked in nasal drops. Naphthyzin and Sanorin help a lot. The tampon should be tight, and it should be inserted deeper into the nasal passage.

It is important not only to know how to stop a nosebleed: you need to be able to correctly assess the situation so as not to waste time on manipulations that are unlikely to help stop the bleeding using improvised means.

If the person’s condition does not improve within the next ten minutes, call an ambulance.

An immediate call to medical personnel is also required in case of heavy bleeding, when blood gushes out like a fountain, and the patient’s general condition quickly deteriorates - he is pale, complains of dizziness, weakness and blurred vision.

There is no need to worry about nosebleeds if they are mild, stop quickly, and occur very rarely. In other cases, you will probably need medical advice and possibly treatment.

Nosebleeds are usually frightening and take you by surprise. Even a few falling scarlet drops cause concern, and if blood is gushing out of your nose, you won’t be confused for long. Knowing why will help you not to panic and competently provide assistance to the victim. there's blood coming out from the nose and how to act to stop it.

Causes of nosebleeds

Epistaxis (nosebleeds) is a common and familiar phenomenon to everyone. There are many reasons for it - from fairly harmless to serious, but what they all have in common is the effect on the blood vessels: they become fragile, burst, which is why the nose bleeds.

Nosebleeds in adults

All causes of epistaxis in adults are divided into:

Local – appear locally and affect only the nose
Systemic – appear due to internal influence and affect the body completely.

Local reasons

Local factors for the occurrence of nosebleeds:

Injury - blows, falls
Entry of foreign bodies
Sharp blowing of the nose, damage to the mucous membrane with nails
Dry indoor air
Inflammatory diseases. With rhinitis, sinusitis, and sinusitis, crusts form in the nose, injuring the mucous membrane, and light bleeding occurs
Allergy - blood vessels burst due to blood flow
Use of steroid and hormonal nasal sprays
Nasal cartilage deformities
Atrophied mucosa
The appearance of tumors
Inhalation of narcotic powders (cocaine is especially dangerous)
Surgeries – plastic and after injuries.

System

Epistaxis occurs for the following systemic reasons:

Disturbances in the functioning of the heart and blood vessels
Increased pressure
Vegetative-vascular dystonia
Diseases of the blood with impaired coagulation
Taking blood thinning medications
Decreased elasticity connective tissue and blood vessels due to a lack of vitamins C, PP and K
Alcohol abuse
Overheating in the sun, fever
Barotrauma - sudden changes in pressure at height or depth
Hormonal imbalances - during adolescence, pregnancy, menopause
Overwork, lack of sleep, stress
Hereditary fragility of blood vessels.

In many cases, nosebleeds appear against the background of headaches, tinnitus, and dizziness.

Nosebleeds in the morning

Epistaxis in the morning, not during the day , more often observed in men. The reasons are deviated septum due to injury or vascular atrophy due to overwork, smoking, and harmful working conditions.

More are possible serious problems– nasal polyps, systemic blood diseases, therefore, with constant bleeding in the morning, especially with pain , Consultation with a specialist is advisable.

Nosebleeds during pregnancy

During pregnancy, under the influence of hormones, the total volume of blood in the body increases and the load on the heart and blood vessels increases.

In a woman in an “interesting position,” the nasal mucosa becomes thinner and brittle, and pressure may increase—as a result, blood flows from the nose. This must be reported to the supervising doctor - monitoring is necessary, high blood pressure dangerous for the fetus.

After childbirth, everything usually returns to normal.

Nosebleeds in children

Why does nose bleed in children?

Age-related immaturity of blood vessels and mucous membranes
Dryness and crusts in the nose due to suffocating air
Injury - blows, picking off crusts with a fingernail
Ingestion of foreign bodies - a child can insert a small toy, button, bead, or pea into the nostril
The use of vasoconstrictor sprays and drops
Straining when sneezing or coughing
Polyps and tumors in the nose
Anomalies of the nasal septum
Vitamin deficiencies
Anemia
Increased pressure
Diseases caused by viruses and bacteria
Pathologies affecting blood clotting and vascular permeability
Hormonal surges during puberty.

Is nosebleed dangerous?

Typically, epistaxis is a frightening, spectacular, but relatively safe for health phenomenon. It develops when blood vessels are damaged spontaneously or due to injury.

Nosebleeds happen:

Anterior - localized in the anterior-lower part of the nasal septum, occurs in 90-95% of cases. Blood drips or flows in a weak trickle, stops quickly
Posterior – occurring in the middle and posterior sections of the nasal cavity. It is observed much less frequently, but requires mandatory medical attention: blood flows in a stream, it is difficult to stop it, and vomiting of blood is possible if it is swallowed.

The danger is heavy or prolonged bleeding. Dizziness, weakness, pallor, flashing spots appear, cold sweat appears, the pulse weakens and quickens, the patient may lose consciousness. If such symptoms appear, you should not hesitate - you need urgent medical help. If blood pours from the nose every day, it appears headache, a medical consultation is also necessary.

How to stop nosebleeds

If the bleeding occurs spontaneously, in one half of the nose, the blood flows out weakly, there is no pain, then it usually stops quickly and is not dangerous to health. Severe or prolonged bleeding requires medical intervention.

Independent actions

In most cases, you can handle the problem yourself. What to do if your nose bleeds:

Provide the patient with a state of rest in a semi-sitting position
You should spread your legs and lean forward slightly so that the blood flows freely
Ensure free access of air - unfasten the belt, tight collar, bra
You need to apply cold to the bridge of your nose - a wet napkin, ice
Blood that enters the nasopharynx should be spat out
If the blood flows weakly, you can slightly press the wings of the nose and hold for 5-7 minutes until the bleeding stops - when squeezed, the blood flow will slow down, a clot will form and block the damaged vessel
If bleeding is severe, cotton swabs should be soaked in hydrogen peroxide or vasoconstrictor drops and insert into the nasal passages
When bleeding due to dry crusts in the nose, they need to be softened by lubricating the nostrils with Vaseline or sunflower oil
If bleeding is due to overheating, the victim should be moved to the shade and a cold compress applied to the nose. Heat stroke will require hospitalization
If you lose consciousness, the patient should be placed on his back with his head turned to the side and doctors should be called.

What NOT to do:

Throwing your head back - this leads to blood flowing into the throat and vomiting
Bend over too much - this will increase bleeding
Blowing your nose prevents a blood clot from clogging the injured vessel.
Lie down horizontally with your head turned to the side.

If a child’s nose bleeds or pain occurs, there is no need to panic, scaring the baby. You need to act in the same way as when providing assistance to adults, but call doctors after 10 minutes if the bleeding has not stopped, and after 5 minutes if there is severe bleeding.

Folk remedies for nosebleeds

It is possible to stop nosebleeds with the help of herbal recipes:

Soak cotton swabs in nettle juice and insert them into the nasal passages
Grind fresh yarrow, soak tampons in the juice and insert into the nostrils
Boil viburnum bark (10g per glass of water), leave, moisten the tampons and insert them into the nose.

When you need medical help

You should urgently call an ambulance if it is impossible to stop the nosebleed on your own, it lasts more than 15-20 minutes in adults or becomes stronger, pallor, chills appear, severe pain, numbness of the limbs or loss of consciousness.

Doctors' help is also needed if:

There is pain, swelling, a deformed bone, there is a suspicion of a nasal fracture
Bleeding is accompanied by headache, blurred vision, and dizziness.
Bleeding after taking blood thinners or hormonal medications
Possible availability foreign body in a child's nose.

Until the doctors arrive, the patient needs to be kept at rest.

Preventing nosebleeds

If adults or children often have nosebleeds, bruises appear on the body, bleeding gums or a headache, it is imperative to establish the exact cause of the pathology.

First of all, you should contact an ENT specialist. To determine the causes of the problem, the specialist will examine the nasal cavity - there may be foreign bodies, polyps, neoplasms, and will prescribe a blood test to determine its coagulability and platelet count.

It is also advisable to seek advice from an endocrinologist, immunologist, hematologist, or oncologist. Specialists will conduct diagnostic tests and prescribe the necessary course of treatment.

To prevent bleeding in adults and children over 3 years of age, use ascorutin (a complex drug with vitamins C and P) in prophylactic doses specified in the instructions.

You can strengthen the delicate surface of the mucous membrane with massage. Every day, morning and evening:

Knuckles thumbs tap in the center of the bridge of the nose
Using the pads of your index fingers, stroke the nasal mucosa at its base with rotational movements.
Tap the wings of the nose - lightly at first, then gradually increase the pressure
At the end of the procedure, lubricate the nasal mucosa with Vaseline.

Has an excellent strengthening effect breathing exercises. You should inhale and exhale forcefully several times, then repeat the exercise, alternately pinching your nostrils. After this, inhale alternately with pinched nostrils, holding the air as you inhale for 5 seconds.

Washing the nose with solutions is very useful. sea salt, soda, iodine, herbal infusions, especially chamomile.

You should also constantly:

Eat well and rest
Maintain comfortable humidity in living areas, especially children's rooms - 60-70%
Make sure that children do not put their fingers or small objects into their noses.
Infants should wear anti-scratch mittens.

The causes of most episodes of epistaxis can be easily identified and eliminated, but they can also be a symptom of serious illnesses or a consequence of neglect of one’s health. Situations are dangerous when blood streams from the nose, this is accompanied by pain and general weakness - urgent medical attention is required here. If bleeding constantly recurs, you also cannot do without a visit to the doctor. Pay attention to your body's signals and be healthy!

Many seemingly minor health problems are actually symptoms of serious illnesses. Nosebleeds in adults often resolve quickly and therefore are not always a cause for concern. However, a negative symptom may only be the tip of the iceberg. So why does your nose bleed? The reason may lie in development serious illness affecting the entire body.

The structure of the nose and its blood supply

The nose is an important part of the human body, performing the function of recognizing odors and purifying the air entering the lungs. In addition, it is an integral part of the appearance of every person.

The basis of the nasal cavity is made up of the bones of the facial skeleton: nasal, ethmoid, vomer, upper jaw. The picture is completed by cartilage. The nasal cavity is divided into two parts by an osteocartilaginous septum. The nasal turbinates, located on the ethmoid bone, form three passages. The upper two communicate with the paranasal sinuses, the lower one serves to drain tears from the eye.

The blood supply to the nasal cavity comes from the ophthalmic artery, which is one of the terminal branches of the internal carotid artery. The latter originates on the lateral surface of the neck in the thickness of the muscle tissue. The largest concentration of vessels is located in the anterior third of the nasal septum - the Kisselbach area. This is where the source of bleeding is most often found.

Why does the nose bleed: local causes

An unpleasant phenomenon in adults is most often not just a negative symptom, but a sign of a serious illness. The reasons for this process may lie inside the nasal cavity.

Rupture of a vessel in the nasal septum

The nasal septum is a very sensitive area, penetrated by plexuses of blood vessels. Most often the cause is their damage. The integrity of the vessel may be compromised by injury. A blow to the face, a fall from your own height, impact from an deployed airbag in a car. In all these cases, one or more vessels rupture, accompanied by the development of bleeding.

Erosion of the vascular wall

The vessel can be damaged not only by direct impact. A long-term inflammatory process in the nasal cavity often causes destruction of the thin vascular wall. The defect in this case is called erosion. The picture is complemented by thinning of the nasal mucosa. Most often, such changes occur against the background of long-term use of vasoconstrictor drugs. Their exposure leads to disruption of the protective function of the mucous membrane. Exposed vessels lose their strength with any, even minor, impact. Erosion will be detected by an ENT doctor when examining the nasal cavity.

Hemangioma

Hemangioma is a benign tumor consisting of a collection of dilated vessels. Often such a formation is located in the nasal cavity. The vessels of the hemangioma differ in structure from those located in the septum. Any minor impact or increased dryness of the mucous membrane leads to massive blood flow. The hemangioma itself does not pose a danger to the body. However, bleeding from its vessels can lead to large blood loss. An otolaryngologist will suspect hemangioma when examining the nasal cavity. It is possible that a microscopic examination of a tumor sample (histology) may be required. .

Angiofibroma of the skull

Angiofibroma is another type benign tumor.Its structure combines dilated blood vessels and connective tissue. Most often, the tumor originates at the base of the skull. As it grows, it penetrates the nasal cavity and can become a source of heavy, recurring bleeding. Angiofibroma of the skull is clearly visible on tomographic images of the head. However, only a histological examination of its sample can accurately determine the nature of the tumor.

Malignant tumors of the nose

In the nasal cavity, as in any part of the human body, malignant tumors can develop. Their source can be any component: bone, connective tissue, blood vessels, mucous membrane. Any malignant tumor lives and spreads due to the enormous consumption of nutrients. That is why such formations are equipped with a large number of vessels. A long-existing tumor corrodes the vascular wall, and therefore there is a high risk of massive bleeding. Suspicion of oncological process in the nasal cavity requires confirmation - computer or magnetic resonance imaging. The type of tumor must be determined by histological examination of the sample.

Causes of nosebleeds - video

Diseases of the body as a cause of nosebleeds

In some cases, it is not easy to establish the cause of repeated attacks in an adult, especially if the disease is hidden deep in the body.

Hypertension

Most adults over the age of forty have high blood pressure. An increase in blood pressure at the onset of the disease is felt by tinnitus and headaches. However, people with thin nasal vessel walls often experience bleeding. Recurring negative symptoms - a reason to measure blood pressure.

Secondary arterial hypertension

High blood pressure is not always a consequence hypertension. Vascular tension is regulated by many factors. The most important role is played by the substance angiotensin, secreted by the kidneys. Any disruption of their work - inflammation (pyelonephritis, glomerulonephritis) or blood deficiency due to cholesterol plaques in the renal vessels leads to increased blood pressure. In addition, the tone of the vascular wall is regulated by hormones: aldosterone, thyroxine, vasopressin, adrenaline, norepinephrine, cortisol. An uncontrolled increase in their production also leads to an increase in blood pressure. Before concluding that hypertension is present, other possible factors must be excluded.

Rondu-Osler disease

Another cause of recurring episodes of nosebleeds is a rare hereditary vascular disease - Rondu-Osler syndrome. Normally, the vascular wall is quite strong and consists of three layers: internal intima, muscular media and external connective tissue adventitia. The hereditary disease leads to a congenital defect in the structure of the vascular bed: the absence of the middle and outer membranes. Such vessels are very thin, and therefore a slight impact can lead to heavy nosebleeds.

Systemic vasculitis

The cause of nosebleeds can be diseases that cause inflammation of the vascular wall - vasculitis. Most of them are based on immune aggression against one’s own tissues and organs, including blood vessels. Such pathologies include:

All these diseases lead to a decrease in the strength of the vascular wall, which causes nosebleeds. Pathology requires confirmation - a histological examination of a tissue sample of the nasal cavity.

Hematopoietic diseases

Hematopoietic diseases are another possible reason frequent nosebleeds. Blood cells - leukocytes, erythrocytes, platelets - are formed in the red bone marrow, undergoing several successive transformations. Any disruption to these processes can lead to repeated episodes. The disease can affect only one part of hematopoiesis - the formation of red blood cells, leukocytes or platelets. Such pathologies include:

To confirm a hematopoietic disease, it is required general analysis blood and microscopic examination of the sample bone marrow, taken by puncture of the sternum.

Liver diseases

The liver is an extremely important part of the human body. It performs many different functions. Not least among them is the formation of substances that help blood clot. Chronic inflammation in the liver (hepatitis), proliferation of connective tissue (cirrhosis) inevitably leads to disruption of this process. A deficiency of blood clotting factors can manifest itself not only in nosebleeds, but also in skin hematomas or internal hemorrhages. Confirmation of liver disease requires a comprehensive examination using analysis, ultrasound, and tomography.

Infectious diseases

Nosebleeds often occur as a result of general infectious disease. A particularly common cause is influenza, a severe viral pathology. The pathogen, penetrating the body, releases specific toxins. As a result, the integrity of the vascular wall is disrupted not only in the nasal cavity, but throughout the body, including the brain. Besides, pathological process can cause more than just nosebleeds. Areas of hemorrhage along the vessels, located throughout the body, pose a great danger. Currently, the diagnosis of influenza requires laboratory confirmation.

Other factors

The phenomenon can develop in a healthy body in the absence of any diseases. Its development can be facilitated by sudden changes in atmospheric pressure. At an altitude of more than 2 thousand meters above sea level, the air pressure is much lower than what residents of flat areas are accustomed to. Being in the mountains, especially for the first time, can cause more than just symptoms oxygen starvation, but also recurring nosebleeds.

An increase in body temperature can also cause a problem. However, the cause of such changes is not always illness. An increase in body temperature may be a consequence of sunstroke or heatstroke, which occurs during prolonged exposure to a stuffy room, bathhouse, sauna, or under the scorching sun.

Another factor - foreign object in the nasal cavity. Most often, a child finds himself in such a situation. Open access to small objects - coins, buttons, parts of toys in combination with children's curiosity becomes the main predisposing factor.

The time of occurrence of nosebleeds may indirectly indicate the cause of the negative symptom. Evening is a period of increased blood pressure. Many brain hemorrhages occur in the afternoon hours. Blood from the nose in the morning often indicates changes in the nasal cavity.

First aid

Providing competent assistance to an adult is an important step towards a favorable outcome of the disease. However, in an emergency situation, mistakes are often made:

First aid algorithm:

Help with nosebleeds - video

Medical assistance

The phenomenon poses a danger to the body of an adult, since it is not always possible to cope with it on your own. You should consult a doctor in the following cases:

ongoing nosebleeds;
massive flow with clots;
severe weakness combined with cold, sticky sweat and rapid pulse;
trauma to the nose and head;
a foreign object in the nasal cavity that caused the phenomenon.

The foreign object must be removed using a special hook. After freeing the nasal passage, the doctor will examine the mucous membrane and identify the source of bleeding. There are several methods to solve the problem.

Anterior tamponade is most often used to stop it. It does not require pain relief and can be used at any age. This is done using a bandage. Expanding the nasal passage with a special instrument - a nasal speculum, the doctor uses tweezers to tamponate it, starting from the bottom.

If the anterior tamponade is ineffective, the posterior one is used. This procedure is more complex, requiring pain relief with potent drugs. Algorithm for posterior nasal tamponade:

However, this procedure may also be ineffective. In this case, ligation of the external carotid artery in the neck is used. If the doctor has visually identified the source of bleeding in the nasal cavity, he can perform the procedure of cauterization of the pathological area using an electrocoagulator, laser, or cryodestruction apparatus.

What to do for prevention

Prevention of nosebleeds includes the following measures:

Bleeding from the nose in an adult is by no means a harmless symptom. It can be called serious reasons, requiring specialist attention. For recurring episodes, not only a consultation with an otolaryngologist is necessary, but also a more in-depth examination.

Types of nosebleeds

The nose is an olfactory organ, richly innervated and equipped with a huge number of vessels. Injured or weak vessels sometimes leak, which is characterized by varying degrees of intensity: in some cases only a few drops leak out, in others moderate or heavy (profuse) bleeding develops.

Nosebleeds are distinguished by the following symptoms:

Localizations;
Frequency of occurrence;
The mechanism and type of damaged vessels;
Volume of blood loss.

Causes of bleeding

Nosebleeds can be caused by various reasons, including: :

High blood pressure- The most common cause of nosebleeds. An increase in blood pressure on the walls of fragile capillaries often breaks them, which is why the nose bleeds. Typically, high blood pressure is often observed in people of retirement age.
Injuries. Mechanical injuries are also one of the common reasons nosebleeds. Blood can come if a person picks his nose, or during a runny nose - when the nose is injured by handkerchiefs, easily injured nasal vessels during ARVI swell and burst.
Drying out. Drying of the mucous membrane occurs in the cold or in dry indoor air and can lead to bleeding.
Poor blood clotting. Nosebleeds can occur with poor blood clotting and also in those who take acetylsalicylic acid and other blood thinning drugs.
Vitamin K. Bleeding caused by poor blood clotting may be associated with a lack of vitamin K. Its sources include spinach, lettuce, all types of cabbage, avocados, bananas, wheat bran, soybeans, meat, eggs, milk and dairy products, and olive oil.
Vitamin C. The condition of blood vessels is affected by vitamin C, a deficiency of which increases their fragility. This explains bleeding in children after illness, when the body is weakened and lacks vitamins, as well as in winter and spring. Therefore, it is important to monitor your diet, especially after illness and during the cold season.
Nasal polyps. Polyps are growths in the nasal mucosa that prevent it from functioning normally. The shoots interfere with breathing and put physical pressure on the blood vessels. With polyps, nosebleeds occur quite often, especially in the morning. In addition, dryness of the nose and the formation of crusts leads to picking and new bleeding.
Vegetovascular dystonia. If spontaneous nosebleeds are preceded by a headache and tinnitus, and nosebleeds occur against the background of watery discharge, then most likely the cause is vegetative-vascular dystonia. Many people, especially children, do not tolerate weather changes well, due to which blood pressure also changes sharply, the vessels either expand or contract, as a result of which their walls cannot withstand and burst.
Hormones. This reason explains nosebleeds in girls during hormonal changes; this phenomenon is called replacement bleeding. The tissue of the nose and the tissue of the genital organs are of the same type, it is called cavernous tissue. If you examine it under a microscope, you can see a very close interweaving of balls blood vessels. Therefore, when, before the onset of menstruation, blood rushes to the genitals, the cavernous tissues of the nose reflexively swell, the vessels overflow with blood, sometimes they cannot stand it, they burst, and bleeding comes from the nose. Usually with the establishment of a permanent menstrual cycle these problems go away in girls, but this does not prevent you from telling your endocrinologist and gynecologist about them during your appointment. By the way, similar hormonal causes of nosebleeds can occur during pregnancy.
Overheat. Blood from the nose is often associated with overheating of the body, for example, in the summer when sunstroke, and in winter - when the temperature rises during flu and respiratory infections.
Sudden changes in barometric pressure. Climbers and divers often suffer from nosebleeds due to the fact that they have to endure sudden changes in pressure.
Overwork. Nosebleeds can appear due to severe overwork, work or study loads, lack of fresh air, lack of sleep, stress, and so on. As a result of all these factors, the walls of blood vessels become fragile and brittle, which causes nosebleeds. Therefore, it is important to carefully monitor your lifestyle, get adequate rest and eat well. In children, 90% of spontaneous nosebleeds occur from the Kisselbach plexus area - this is a place at the lower edge of the nasal septum, where there is a very dense network of branched blood vessels. In children, the vessels are located close to the surface, while the mucous membrane is thin, so any damage to the mucosa and sudden dilation of the vessels can cause bleeding.

Diseases of the body as a cause of nosebleeds

In some cases, it is not easy to establish the cause of repeated attacks in an adult, especially if the disease is hidden deep in the body.

Hypertension

Most adults over the age of forty have high blood pressure. An increase in blood pressure at the onset of the disease is felt by tinnitus and headaches. However, people with thin nasal vessel walls often experience bleeding. Repeated negative symptoms are a reason to measure your blood pressure.

Secondary arterial hypertension

High blood pressure is not always a consequence of hypertension. Vascular tension is regulated by many factors. The most important role is played by the substance angiotensin, secreted by the kidneys. Any disruption of their work - inflammation (pyelonephritis, glomerulonephritis) or blood deficiency due to cholesterol plaques in the renal vessels leads to increased blood pressure. In addition, the tone of the vascular wall is regulated by hormones: aldosterone, thyroxine, vasopressin, adrenaline, norepinephrine, cortisol. An uncontrolled increase in their production also leads to an increase in blood pressure. Before concluding that hypertension is present, other possible factors must be excluded.

Rondu-Osler disease

Systemic vasculitis

giant cell temporal aortoarteritis;
aortoarteritis;
Tokayasu disease;
Wegener's granulomatosis;
Charge-Strauss syndrome;
Kawasaki disease;
microscopic polyangiitis;
periarteritis nodosa.

Hematopoietic diseases

Hematopoietic diseases are another possible cause of frequent nosebleeds. Blood cells - leukocytes, erythrocytes, platelets - are formed in the red bone marrow, undergoing several successive transformations. Any disruption to these processes can lead to repeated episodes. The disease can affect only one part of hematopoiesis - the formation of red blood cells, leukocytes or platelets.

Such pathologies include:

anemia (anemia);
malignant tumor of the white sprout of the bone marrow - leukemia;
myeloma – a tumor of a certain type of white blood cells;
thrombocytopenia is a disease in which insufficient blood platelets - platelets - are formed in the bone marrow.

To confirm the hematopoietic disease, a complete blood count and microscopic examination of a bone marrow sample taken by puncture of the sternum is required.

Liver diseases

Infectious diseases

Nosebleeds often occur against the background of a general infectious disease. A particularly common cause is influenza, a severe viral pathology. The pathogen, penetrating the body, releases specific toxins. As a result, the integrity of the vascular wall is disrupted not only in the nasal cavity, but throughout the body, including the brain. In addition, the pathological process can cause not only nosebleeds. Areas of hemorrhage along the vessels, located throughout the body, pose a great danger. Currently, the diagnosis of influenza requires laboratory confirmation.

First aid measures for nosebleeds

Usually, when a nosebleed occurs, out of habit, we reflexively throw our heads up, pressing a handkerchief or napkin to our nose. Unfortunately, this is a common and dangerous misconception; you should not tilt your head up during nosebleeds.

This can lead to ingestion and inhalation of blood, especially if there is severe bleeding, vomiting, and bronchial obstruction (blood blockage). It is necessary to sit down and lean your head forward, looking between your spread legs, this is necessary so that the blood from the wings of the nose flows forward.

In addition, it is necessary to calm down and allow air to flow by unfastening a woman’s tight belt, shirt collar or bra. If bleeding occurs at home, apply a piece of frozen meat or an ice cube to the bridge of your nose; this will constrict the blood vessels and stop the bleeding faster.

If the bleeding does not stop, you can press your nostril against the nasal septum for about ten minutes. By squeezing the vessels and slowing down the blood flow in them, a blood clot quickly forms there, which clogs the vessel.

If these measures do not help, you can try using vasoconstrictor drops used for a runny nose - naphthyzin, sanorin. Having made a cotton swab and soaked it in the medicine, insert it into the nasal cavity as tightly and deeply as possible. If the bleeding is caused by dry crusts in the nose from a runny nose, it is necessary to lubricate the nasal cavity vegetable oil or Vaseline, this will soften the crusts and stop the bleeding.

If nosebleeds are caused by overheating, take the victim into the shade and place a cool compress on the nose area. If heatstroke is suspected, the person should be examined immediately by calling ambulance and hospitalizing the victim.

When is medical help needed?

Sometimes nosebleeds are one of the symptoms of serious illnesses, so you should immediately seek help from a doctor if:

suspected fracture of the nose, bleeding from the nose and severe deformation in the area of the nasal bone, swelling and pain.
if nosebleeds occur during or after taking aspirin, heparin or any other medicines, especially hormonal ones.
with bleeding from the nose due to headache, darkening of the eyes or dizziness. At the same time, measure your blood pressure, go to bed or sit down if you are out and about.

It is necessary to call doctors if the bleeding does not stop for more than fifteen minutes or if it intensifies, is accompanied by pallor and coldness of the extremities, loss of consciousness, or occurs against the background of a head injury.

See your doctor and get tested if you have recurring episodes of bleeding with bruising, bruising, or bleeding gums. Another reason to contact an ENT doctor is nosebleeds in a child or adult, especially if there is a suspicion of a foreign body in the nose. Only a doctor can correctly and accurately remove the object and stop the bleeding.

If you experience repeated nosebleeds, you will need to be thoroughly examined by a general practitioner and an ENT doctor. If necessary they can send you to additional research- blood for hormone levels, ECG or ultrasound of the heart. However, in most cases, bleeding episodes have visible and easily treatable causes.

Treatment of nosebleeds

After examination, determining the degree and cause of bleeding, the doctor chooses a method to stop it and, if necessary, further treatment.

Specialized medical care consists of the following measures:

Nasal tamponade is a method of stopping nosebleeds by introducing tampons soaked in one of the hemostatic agents, for example, thromboplastin, into its cavity. A hemostatic sponge, which contains thromboplastin and thrombin, helps well. Depending on the situation, the doctor makes an anterior tamponade - from the side of the nostrils, or a posterior tamponade - from the pharynx.
Cauterization of bleeding vessels. There are many ways. Some acids are used as cauterization agents - lactic, trichloroacetic or chromic. Zinc salts, alum, tannin, and silver nitrate solution are also used.
Highly efficient modern methods stopping nosebleeds is ultrasound disintegration (intentional destruction of the existing blood supply to hypertrophied nasal turbinates using an ultrasonic waveguide), laser therapy (laser coagulation), exposure to liquid nitrogen (cold cauterization), electrocoagulation (electric cauterization).
For frequent bleeding accompanied by significant blood loss, it is indicated surgery, which consists of ligating large vessels and arteries, as well as detachment of the periosteum at the site of bleeding, leading to the desolation of blood vessels.

It is important to know that nosebleeds are not always harmless. It is often a symptom of serious illnesses. If it is strong and for a long time does not stop, and even more so often repeats, leading to a worsening of the condition, then you should definitely consult a doctor for a detailed examination in order to determine the causes of epistaxis and choose a method of qualified treatment.

How to prevent recurrent bleeding?

To reduce the likelihood of recurrent nosebleeds, you must follow some simple rules:

There is no need to touch your nose during the healing process, try to blow your nose as little as possible.
It is necessary to use a saline solution to moisten the nasal mucosa. For the same purposes, you can use Vaseline, a drop of which must be applied to the inner surface of each nostril.
To prevent recurrent bleeding, it is also important to monitor the humidity in the room. Use humidifiers for this.
To maintain a sufficient level of moisture in the nasal cavity, you need to drink as much fluid as possible: five to six glasses of water a day will be enough.
Whenever possible, replace aspirin or other non-steroidal anti-inflammatory drugs with acetaminophen. But do not forget to consult your doctor.

Nosebleeds in an adult may appear periodically or at irregular intervals. It is important not to get confused and stop the bleeding coming from the nose in time.

Nosebleeds are called epistaxis and can occur at any age.

The causes of this phenomenon can be varied and result from other diseases. If nosebleeds occur frequently, it is necessary to undergo a full diagnosis to identify the cause and prevent possible complications with health.

Symptoms and signs of bleeding

More than half of cases of nosebleeds indicate that it comes as a complete surprise to a person, causing a feeling of fear and confusion. At the same time, it is important to be able to stop the bleeding in order to prevent significant loss.

Epistaxis is distinguished by the types and amount of blood released:

Bleeding can be anterior and posterior (involving the front and back walls of the nose, respectively), as well as unilateral and bilateral (from one or two nostrils).

Blood loss from the anterior wall of the nose as a result of vascular damage is considered easier; posterior nosebleeds can be stopped without qualified medical care difficult.

Is nosebleed dangerous?

The loss of a large volume of blood is frightening not only for its visual signs, but also is fraught with health complications and the development of anemia. If the vessels of the anterior wall of the nose are damaged, in most cases such bleeding is not dangerous.

If blood loss is abundant or occurs frequently, this is already a dangerous symptom.

It is important to realize that epistaxis signals problems in the body in women, men and children, and accurate diagnosis will prevent the development of complex diseases of the circulatory and endocrine system in the initial stages.

Causes of nosebleeds

TO local characteristics nosebleeds include:

Mechanical injuries of the nasal septum;
Congenital predisposition to vascular rupture due to anatomical features structure of the nose;
Result of surgery;
Inhalation exposure chemicals or dry air in winter.

The causes of bleeding can also be the presence of hidden inflammatory processes in the nasal cavity.

Common factors that cause nosebleeds:

Diagnosis and treatment methods

Correctly determining the cause of nosebleeds includes analyzing the patient's symptoms, general examination, examination and drawing up a complete clinical picture.

At the same time, all indicators related to the problem being studied are studied: the presence of hemoptysis, associated injuries, anatomical structure nasal septum and vascular condition. A comprehensive examination allows the doctor to draw up a reliable picture of the disease.

During the general examination, special attention is paid to the condition of the oropharynx, rhinoscopy and pharyngoscopy are performed. Complete the picture and visual inspection Blood test data, studying the level of hemoglobin, red blood cells and white blood cells help. Blood clotting is studied separately using a coagulogram.

Specific treatment acts simultaneously in several directions:

Prevents recurrent bleeding;
Replenishes blood loss and its consequences in the form of weakness, anemia and loss of consciousness.

To stop minor bleeding, just squeeze your nose with your fingers and then apply ice or a cold wet cloth. It is allowed to swab the nostrils with a swab moistened with 3% hydrogen peroxide.

If the cause of blood loss is anemia, then you need to increase the consumption of foods with high content iron: buckwheat, dried apricots, beef liver, pomegranate and soy-based products.

Blood pressure increases or increases when taking appropriate medications.

After recovery, regular visits to the doctor are necessary for monitoring. general condition and relapse prevention.

Preventing nosebleeds

To prevent blood loss, it is imperative to create conditions to prevent the causes of its occurrence. The air in the room should be of sufficient humidity, free of dust, chemicals and other irritants, and it is recommended to rinse the nose with saline solutions.

At the same time, special attention is paid to protection from mechanical injuries and prevention of allergies and ARVI. Monitoring your blood pressure will help prevent unexpected bleeding as a result of blood pressure surges.

Breathing exercises will strengthen the walls of blood vessels and increase the resistance of the mucous membrane to damage.

Adequate nutrition and proper rest will help reduce the risk of relapse of the disease.