08 Nov Nosebleeds: When to see a doctor?

Epistaxis - that's the medical term for something you've probably had before: A nosebleed. In most cases, it looks worse than it is. But sometimes blood leaks from the nose more frequently or the bleeding cannot be stopped. In this article, we explain when nosebleeds can be a sign of a (serious) illness and when you need to see a doctor.

Basics about nosebleeds

Blood leaks from the nose when the fine vessels in the nasal mucosa, which is heavily supplied with blood, are damaged. If the leaking blood is dark red in colour, it is venous blood. If it is rather light red in colour and spurts out of the nose, it is blood from the arteries. Generally, most haemorrhages occur in the anterior part of the Noseas several blood vessels converge here. They are usually harmless. The situation is different if the epistaxis originates at the back of the nose. Here, the supplying vessels are not as finely branched as in the front of the nose. A "leak" is therefore larger here.

Possible causes of nosebleeds

Local causes

The cause of the nosebleed is located inside the nose. It can be triggered by the following factors:

Blowing your nose vigorously or sneezing can cause small veins in the nose to burst. If the nasal mucosa is irritated (e.g. due to heating air or prolonged use of decongestant Nasal spraythe risk of blood loss is increased.
Epistaxis can also be caused by a blow to the nose or a fall, as well as by a Nasal bone fracture are caused.
If the nasal mucosa is injured by a foreign body (e.g. a Lego brick or a marble in children) or by picking the nose, it can also start to bleed.
Patients who suffer from a septal perforation and have a hole in the nasal septum can suffer from a bleeding nose from time to time. Other malformations can also be the cause, such as protruding bony ridges that injure the nasal mucosa. Incidentally, such findings are often accompanied by a Curvature of the nasal septum on.
In rare cases, a tumour in the nasal cavity or paranasal sinuses may be behind severe and recurrent nosebleeds. This can be benign or malignant.

Systemic causes

Nosebleeds can also be associated with certain diseases:

Feverish illnesses such as flu or measles favour increased blood flow to the mucous membranes, which is why the nasal mucosa is even more sensitive.
During colds, the nose is strained by frequent blowing, which can cause it to bleed.
Nosebleeds can also be a symptom of kidney disease.
The haemorrhage may also be associated with vascular and circulatory diseases or congenital functional disorders of the blood platelets.
Leukaemia and certain autoimmune and hereditary diseases such as haemophilia, Wegener's disease or Osler's disease can be associated with nosebleeds.
Severe bleeding from the oesophagus can also come from the nose and mouth. They then look like nosebleeds.

Side effects of medication

Platelet aggregation inhibitors and coumarin derivatives (blood thinners) can favour bleeding from the nose. Examples of this are acetylsalicylic acid or Marcumar.
Certain antibiotics and psychotropic drugs can also cause nosebleeds.

When should you see a doctor if you have a nosebleed?

If the bleeding is exceptionally heavy or you can see a visible injury to your nose, you should seek medical advice. This also applies if you cannot stop the nosebleed after about 20 minutes (10 minutes for children). In this case, there is a risk of excessive blood loss. You should now be admitted as an emergency to our ENT practice in Frankfurt come. If you feel that the blood is not coming from the front of the nose, but mainly down the throat, the injury is probably coming from the upper/rear part of the nose. In this case, you should also come to us for an examination. Please also make an appointment if your nosebleeds occur more frequently (e.g. several times a week). In this case, it is necessary to clarify the cause.

Investigations for repeated nosebleeds

If you experience epistaxis frequently, we will carry out certain examinations after taking your medical history. This includes examining the anterior nasal cavity with a rhinoscope and the posterior nasal cavity with a ENT endoscope. An ultrasound examination can provide additional information. If necessary, we can call in the radiology department and have an MRI or CT scan carried out. We can also identify any coagulation disorders or inflammation by analysing the blood.

If we cannot find a cause in the field of ENT medicine, we can consult your general practitioner for a diagnosis to clarify other physical causes.

How we can treat nosebleeds

Depending on the type and severity of your nosebleed, we have various options to stop it:

Decongestant nasal sprays
Sclerotherapy by laser or electrocoagulation
Tamponades

Nosebleeds: Treatment at the Goethe10 practice clinic

If you are affected by acute nosebleeds and need help: In our Goethe10 Practice Clinic in Frankfurt we will be happy to help you. Dr Thomas Fischer is your experienced ear, nose and throat specialist.

ENT Frankfurt: Dr Thomas Fischer & Dr Albrecht Linke

Your specialists for ear, nose and throat medicine, who will provide you with professional and individualised advice, examinations and treatment in all matters relating to ENT medicine, functional plastic surgery and the aesthetic treatment of changes to the facial skin.

Our news articles are prepared for you to the best of our knowledge and belief and are intended for general education. They are in no way a substitute for medical advice, diagnosis and treatment and are not intended to encourage self-diagnosis or self-treatment. Please always contact your ENT specialist in Frankfurt directly if you have any health complaints!

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ENT, ENT doctor, ENT doctor Frankfurt, ENT medicine, Nose, Nosebleed, Nasal pain