Why Does The Nose Bleed?

It is a piece of jewelry on the face that has two long holes called nostrils and both are exactly the same and are separated by a small wall called the nasal septum.

The nasal septum is made of cartilage and very thin pieces of bone. Kids Health explains that the nose doesn’t just breathe air in and deliver it to the lungs – it warms it, humidifies it, and filters it first (to humidify means to add moisture).

The inside of the nose is lined with a mucous membrane, which is a thin, moist layer of tissue. This membrane warms the air as it passes through and humidifies it. The air entering the nose reaches almost 75% humidity.

Internist Aldrin Aroche says that nosebleeds are known medically as epistaxis and are quite common, especially among children and adolescents, but can also occur at other ages.

“The structure of the nose is very vascularized (that is, full of blood vessels, which transport blood throughout the body ) and the part that is in most contact with the environment has an area called the Kiesselbach plexus, which has an abundant network of small vessels and 90% of epistaxis comes from there,” describes Dr. Aroche.

Most of the time, nosebleeds should not represent a major problem, but it is necessary to evaluate how and in what form it occurs.

Causes of nosebleeds

Bleeding occurs when sensitive blood vessels in the nose break. The causes are diverse, from climate change, such as the current heat in the world because the vessels dilate and break, dryness, scratching, some medications, and blows or injuries.

“Usually it is not something to worry about, some people due to genetics are more sensitive to changes in the environment and changes in atmospheric pressure,” says Aroche.

However, experts say that bleeding can also occur as a result of other diseases. Blood pressure can manifest itself in this way, although it is rare.

Other patients who sometimes face this experience are those who suffer from allergic rhinitis, “there are populations sensitive to pollen and bleeding could appear at different times when the nasal mucosa dries out a lot,” says Aroche.

There are also other causes of more specific issues such as having coagulation problems, which is the body’s ability to stop bleeding when it appears, adds the internist. Nosebleeds can be worse in people who are on treatment with anticoagulants.

Hematologist Silviana Oliva adds that at a systemic level, there could be other causes that go unnoticed, such as the coagulation problems mentioned above. “This causes a tendency to bleed more than usual and is called coagulopathy,” says Oliva.

Up to 1% of the population may have an undiagnosed disorder, which is why it is important to see a doctor early and undergo the appropriate tests.

Coagulopathies can be congenital, i.e. present from birth, and also acquired. The latter include hemophilia, von Willebrand disease, platelet disorders, as well as hereditary deficiencies in coagulation factors, among others. There are also connective tissue defects, platelet disorders, consumption of certain foods that make the blood thinner, and problems with coagulation factors when there are liver conditions.

Oliva indicates that it is essential to see if there is bleeding only in the nose or also at other levels such as women with heavy menstrual periods, those who bleed when brushing their teeth, bruises from carrying something, as well as blood in the stool.

What to do and what not to do when our nose bleeds?

The ideal position is for the person to remain calm and lean forward rather than backward, say the experts consulted. When leaning forward, it is important to press the nose to create compression in the network of blood vessels. This process should not take more than 20 minutes.

Do not insert any objects or apply medication into the nose, say the doctors consulted. Cold compresses on the forehead may help.

If the bleeding is very heavy, too frequent, or lasts too long, it is best to go to the doctor. Likewise, those who take clotting medication should receive medical attention.

An emergency could occur when the bleeding is more than one vessel, if the patient has anemia, and if despite local measures, the bleeding does not stop.

Health professionals must determine the cause of the bleeding. The doctor must consider whether the person is young and healthy, or whether the person has another disease that may predispose them to this, Aroche adds.

Although general practitioners and internists may be the first to see the case at first, when there are more underlying causes for the bleeding, it may be necessary to go to an otorhinolaryngologist or a hematologist, among other specialties.

What vitamin should you take if you have a nosebleed?

When evaluating a patient, there is no special vitamin to recommend, says Aroche, since the ideal for everyone is to have a complete diet that meets their requirements.

Aroche clarifies that in a complete evaluation if vitamin K deficiency is diagnosed, the person could be prescribed its use, although this is rare in adults because food is usually sufficient.

Vitamin K deficiency does cause an increased risk of bleeding. Deficiency is particularly common among breastfed infants. Diagnosis is suspected by routine coagulation studies and confirmed by response to vitamin K. Treatment consists of giving vitamin K orally or, when the cause is malabsorption or, when the risk of bleeding is high, parenterally, describes the MSD Manual, from Merck & Co, Inc.