Nosebleeds.

Etiology

The cause of nosebleeds can generally be divided into two categories, local and systemic factors, although it should be remembered that a significant number of nosebleeds occur with no obvious cause.
[edit]Local factors
Anatomical deformities (e.g. septal spurs or Osler-Weber-Rendu Syndrome)
Blunt trauma (usually a sharp blow to the face, sometimes accompanying a nasal fracture)
Foreign bodies (such as fingers during nose-picking)
Inflammatory reaction (e.g. acute respiratory tract infections, chronic sinusitis, allergic rhinitis or environmental irritants)
Insufflated drugs (particularly cocaine)
Intranasal tumors (e.g. Nasopharyngeal carcinoma or nasopharyngeal angiofibroma)
Low relative humidity of inhaled air (particularly during cold winter seasons)
Nasal prong O2 (tending to dry the olfactory mucosa)
Nasal sprays (particularly prolonged or improper use of nasal steroids)
Otic barotrauma (such as from descent in aircraft or ascent in scuba diving)
Surgery (e.g. septoplasty and Functional Endoscopic Sinus Surgery)
[edit]Systemic factors
Drugs – Aspirin, Fexofenadine/Allegra/Telfast, warfarin, ibuprofen, clopidogrel, isotretinoin, desmopressin, ginseng and others
Alcohol (due to vasodilation)
Allergies
Anemia
Connective tissue disease
Blood dyscrasias
Envenomation by mambas, taipans, kraits, and death adders
Heart failure (due to an increase in venous pressure)
Hematological malignancy
Hypertension
Idiopathic thrombocytopenic purpura
Infectious diseases
Pregnancy
Vascular disorders
Vitamin C or Vitamin K deficiency
von Willebrand's disease
[edit]Pathophysiology

Nosebleeds are due to the rupture of a blood vessel within the richly perfused nasal mucosa. Rupture may be spontaneous or initiated by trauma. Nosebleeds are reported in up to 60% of the population with peak incidences in those under the age of ten and over the age of 50 and appears to occur in males more than females.[2] An increase in blood pressure (e.g. due to general hypertension) or local blood flow (for example following a cold or infection) will increase the likelihood of a spontaneous nosebleed. Anticoagulant medication and disorders of blood clotting can promote and prolong bleeding. Spontaneous epistaxis is more common in the elderly as the nasal mucosa (lining) becomes dry and thin and blood pressure tends to be higher. The elderly are also more prone to prolonged nose bleeds as their blood vessels are less able to constrict and control the bleeding.
The vast majority of nose bleeds occur in the anterior (front) part of the nose from the nasal septum. This area is richly endowed with blood vessels (Kiesselbach's plexus). This region is also known as Little's area. Bleeding further back in the nose is known as a posterior bleed and is usually due to rupture of the sphenopalatine artery or one of its branches. Posterior bleeds are often prolonged and difficult to control. They can be associated with bleeding from both nostrils and with a greater flow of blood into the mouth.[3]
[edit]Treatment

The flow of blood normally stops when the blood clots, which may be encouraged by direct pressure applied by pinching the soft fleshy part of the nose. This applies pressure to Little's area, the source of the majority of nose bleeds and promotes clotting. Pressure should be firm and be applied for at least five minutes and up to 20 minutes, tilting the head forward will help decrease the chance of nausea and airway obstruction.[4] Swallowing excess blood can irritate the stomach and cause vomiting. Local application of an ice pack to the forehead or back of the neck or sucking an ice cube has seen widespread practice, but has been shown to not have any statistically significant effects on nasal mucosal blood flow.[5] There are conflicting opinions in the use of ice or nasal packing in the treatment of nose bleeds, most suggest there is no detriment to using ice or nasal packing when initial efforts to pinch the nose fail,[6][7] while others advise against it.[8]
The local application of a vasoconstrictive agent has been shown to reduce the bleeding time in benign cases of epistaxis. The drugs oxymetazoline or phenylephrine are widely available in over-the-counter nasal sprays for the treatment of allergic rhinitis, and may be used for this purpose.[9]
Other products available promote coagulation include Coalgan (in Europe) or NasalCEASE (in the US). These are a calcium alginate mesh or swabs that is inserted in the nasal cavity to accelerate coagulation.[10][11]
If these simple measures do not work then medical intervention may be needed to stop bleeding, possibly by an otolaryngologist (ENT doctor). In the first instance this can take the form of chemical cautery of any bleeding vessels or packing of the nose with ribbon gauze or an absorbent dressing (called Anterior nasal packing). Such procedures are best carried out by a medical professional. Chemical cauterisation is most commonly conducted using local application of silver nitrate compound to any visible bleeding vessel. This is a painful procedure and the nasal mucosa should be anaesthetised first, preferably with the addition of topical adrenaline to further reduce bleeding. If bleeding is still uncontrolled or no focal bleeding point is visible then the nasal cavity should be packed with a sterile dressing, which by applying pressure to the nasal mucosa will tamponade the bleeding point. Ongoing bleeding despite good nasal packing is a surgical emergency and can be treated by endoscopic evaluation of the nasal cavity under general anaesthesia to identify an elusive bleeding point or to directly ligate (tie off) the blood vessels supplying the nose. These blood vessels include the sphenopalatine, anterior and posterior ethmoidal arteries. More rarely the maxillary or external cartoid artery can be ligated. The bleeding can also be stopped by intra-arterial embolization using a catheter placed in the groin and threaded up the aorta to the bleeding vessel by an interventional radiologist. Continued bleeding may be an indication of more serious underlying conditions.[12]
Chronic epistaxis resulting from a dry nasal mucosa can be treated by spraying saline in the nose three times per day, lubricating the nose with ointments or creams, such as vasoline, and installing a humidifer in the bedroom.
Application of a topical antibiotic ointment to the nasal mucosa has been shown to be an effective treatment for recurrent epistaxis.[13] One study found it to be as effective as nasal cautery in the prevention of recurrent epistaxis in patients without active bleeding at the time of treatment - both had a success rate of approximately 50 percent.[14]
Many young children have chronic nosebleeds caused by allergies to dairy products.[citation needed] Parents of young children with recurrent nosebleeds should investigate milk product avoidance as a first step. In these cases, use of humidifiers, nasal sprays, etc. generally do not stop the seemingly random case of nosebleeds and this is where allergy is of primary consideration.
Nosebleeds are rarely dangerous unless prolonged and heavy. Nevertheless they should not be underestimated by medical staff. Particularly in posterior bleeds a great deal of blood may be swallowed and thus blood loss underestimated. The elderly and those with co-existing morbidities, particularly of blood clotting should be closely monitored for signs of shock.
Recurrent nosebleeds may cause anemia due to iron deficiency.

Wow. Thanks for that. Though, it's from wiki, isn't it?

Well, doesn't matter. I'll still read it.

I used to get nose bleeds all the time. I went to the doctor and got my nose cauterized and haven't had one in months! I think that might be the solution for you. It has to do with the vains or something being too close to the skin inside your nose.

Cauterize (as in burn or freeze) your nose? No thanks!

[quote name='Tropicana' post='1859641' date='Mar 29 2009, 10:56 PM']I had ANOTHER nosebleed, from the same nose.[/quote]
DEAR LORD.

Its burn, but they put some sort of liquid to numb it and you dont feel a thing. Just a little tickle. Its defiantly worth it if you get messy, frequent nosebleeds.

I'm not burning my nose just for nosebleeds!

Your not even the one with the nosebleed problems.

Doesn't matter, I will not burn my nose for the sake of a nosebleed.

[quote name='wchill' post='1859683' date='Mar 30 2009, 05:23 PM']Doesn't matter, I will not burn my nose for the sake of a nosebleed.[/quote]

Why not, its not going to damage the nose, it's numbed so no pain, and if you regularly suffer from nose bleeds and know how much of a hassle it is I'm sure you'd be running to the doctor, providing the thats what the doctor thinks should be done.

You're BURNING your nose. No.

[quote name='Gore' post='1859666' date='Mar 30 2009, 06:13 AM'][quote name='Tropicana' post='1859641' date='Mar 29 2009, 10:56 PM']I had ANOTHER nosebleed, from the same nose.[/quote]
DEAR LORD.
[/quote]
AHAHAHAHAHAHAH. I CAN'T BELIEVE I SAID THAT. IT'S FIXED NOW.

I MEANT TO SAY THAT I HAD A NOSEBLEED, FROM THE SAME PLACE AS THE ONE BEFORE.

That sucks... I think I've only had a nosebleed once or twice in my life.

PS: I just got an even worse picture in my head of the conditions of a McDonalds kitchen...

[quote name='War' post='1860426' date='Mar 30 2009, 03:21 PM']PS: I just got an even worse picture in my head of the conditions of a McDonalds kitchen...[/quote]
Don't worry. The heat will kill the germs

[quote name='War' post='1860426' date='Mar 30 2009, 10:21 AM']That sucks... I think I've only had a nosebleed once or twice in my life.

PS: I just got an even worse picture in my head of the conditions of a McDonalds kitchen...[/quote]
Lucky you! I've had tons of nose bleeds in my life time. Probably due to nose picking I will admit

[quote name='wchill' post='1859694' date='Mar 30 2009, 05:31 AM']You're BURNING your nose. No.[/quote]
shut up. you're not even the one with the problem. all you're saying is no no no no no. leave this damn thread if you are either a troll or just too pussy to think about anything that might even cause slight pain.

On the subject, i would highly recommend you get that treatment done if you get nosebleeds as often as you say you do. It's a one time thing, and ya, I do think it hurts afterwards when the anesthetic wears off but it will be worth it as you're free from the rest of your life. If you are noticing repeated nosebleed from the same nostril then it is probably because their are too many veins in that nostril and one of the vessels in their ruptures often because of it. Burn some of them out and be free with it. Ask your doctor about it if you're curious.

[quote name='War' post='1860426' date='Mar 30 2009, 09:21 AM']That sucks... I think I've only had a nosebleed once or twice in my life.[/quote]
Go play some sports, that'll fix it.

Thanks for all the replies guys! I'll check up with a docter whenever I have time. Thanks again!

PS. In case you're wondering about the conditions of a McDonalds kitchen, it's actually pretty clean. Everything is sanitized, we pick up after any sort of mess, and we have to mop the floor whenever we're not busy. It's definately better than one may expect, imo.

Random nosebleeds? Are you an animé?

I hate them, I have them more often in the summer when its hot and humid. Worst places I've had it though was in English Class (that really sucked... when is class over, well I gotta do this packet, OH SHIT BLOOD, damn it why'd I get stuck with all the squeemish girls in my table) and while swimming. You know how you just swallow water and it comes out your nose and stuff, that's what I thought it was until my dad told me I was having a nosebleed and the other kids (public pool lol) were running out. Neither were as bad as in someones potential Big Mac though lol.