Nosebleeds

Overview
A nosebleed is sudden bleeding from one or both nostrils. Nosebleeds are very common and it is estimated that roughly 60 percent of people have experienced a nosebleed. For the most part, nosebleeds are a minor medical problem and usually resolve on their own. Some common reasons for your nose to bleed include trauma to the nose, breathing dry air, allergies or a sinus infection. More serious (and not as common) reasons include tumors, bleeding disorders and head or neck aneurysms. Nosebleeds can occur in the front of the nose (anterior bleed), which is where the majority of nosebleeds occur, or in the back of the nose (posterior bleed). Posterior bleeds tends to cause more significant bleeding than anterior bleeds. Only your health care provider can determine if you have an anterior or posterior bleed. However, most minor nose bleeds that resolve on their own are safely assumed to be anterior bleeds.

Treatment
To stop the flow of blood from a common nosebleed:
1. Immediately sit or stand upright to slow the flow of blood to your nose. Don't tip your head back, as you will swallow blood.
2. Bend slightly forward at the waist to further decrease the risk of swallowing blood.
3. Pinch the sides of the nose, right underneath the bridge (the hard part of the nose). Hold pressure for at least 5 minutes. Resist the temptation to check if the bleeding has stopped before your 5 minutes have lapsed.
4. Try mouth breathing and avoid blowing, wiping, or rubbing your nose.
5. If bleeding continues for more than 20 minutes or increases in volume, seek medical help.

Complications
Occasionally, nosebleeds can cause pretty significant bleeding and will not stop on their own. Significant or recurring nosebleeds are often treated by a trained profession with cauterization, which is the "burning" of the blood vessels through chemical or electrical means. If cauterization is ineffective, the nose can be packed with a special gauze. Posterior bleeds often require more aggressive treatment with a catheter that has a balloon on the tip. The catheter is inserted into the bleeding nostril and the balloon is inflated over the area of the bleed. This usually provides enough pressure to stop the bleeding. If you have recurrent or severe nosebleeds, it is recommended that you discuss this with your health care provider. Most patients are referred to an ear, nose and throat specialist for further evaluation and treatment.