Causes of nosebleeds: why does the nose bleed

Nosebleeds are the most common of all types of bleeding and occur in the practice of every doctor, regardless of his specialty. In almost 85% of cases, nosebleeds are symptoms of other somatic diseases, and only in 15% of cases, nosebleeds are caused by pathology of the nasal cavity. It is enough for each person to know about the rules and methods for stopping nosebleeds. But every doctor should also be aware of the causes that can provoke nosebleeds, as well as the necessary amount of diagnostic measures in the event of a condition such as nosebleeds.

The main types and causes of nosebleeds

There are two main types of nosebleeds: traumatic, which are often caused by pathology of a local nature, and symptomatic, the cause of which can be both in the pathology of the nasal cavity, and in the pathology of the whole organism. Traumatic nosebleeds occur after domestic injuries, surgical intervention in the nasal cavity, wounds, and so on. Traumatic nosebleeds can be mild, single with the release of a small amount of blood, or severe, in which damage to the ethmoid labyrinth and profuse bleeding from the nose occurs. Symptomatic nosebleeds are a sign of a general pathology of the body. Most often, symptomatic nosebleeds are provoked by the pathology of the cardiovascular system, kidney disease, diseases of the blood and blood-forming organs. Much less often, blood from the nose can cause neoplasms of the nasal cavity and sinuses, or factors such as beriberi, excessive exercise, overheating of the body, low atmospheric pressure. Discharge of blood from the nose may accompany gynecological pathology: vicarious nosebleeds occur instead of absent menstruation, and concomitant may accompany them.

Clinical presentation and classification of nosebleeds

Nosebleeds often come on unexpectedly, with red blood coming from the nose that does not foam or may run down the back of the throat. Nosebleeds may be accompanied by symptoms such as headache, tinnitus, itching or tickling in the nasal cavity, weakness and dizziness. Depending on the volume of blood loss, there are three types of nosebleeds:

• with minor nosebleeds, nose bleeds for a short time, in the amount of only a few milliliters, the bleeding stops as spontaneously as it started;
• with moderate nosebleeds, more volumetric blood loss occurs, but not exceeding 300 ml for an adult, no changes in hemodynamics are observed;
• In case of massive epistaxis, blood loss can reach more than 1 liter and is a life-threatening condition for the patient.

What diagnostic methods will help to clarify the cause of nosebleeds

Often, the occurrence of a single minor nosebleed should be thought of as a traumatic etiology. There is only a rhinoscopy, which helps to determine the source of bleeding. With minor bleeding, blood from the nose is often released from the Kisselbach zone, located in the anterior third of the nasal septum. If it is not possible to determine the source of nosebleeds during rhinoscopy, endoscopic examination is necessary. nasal cavity with the help of special probes, since the source of bleeding may be in the deep parts of the nasal cavity. In the presence of prolonged, often recurrent bleeding, a much larger volume of diagnostic studies is needed. The patient undergoes a general and biochemical blood test, coagulogram, thromboelastogram, that is necessary for the study of the patient's hemodynamics. Blood pressure is measured, in some cases it is necessary to biopsy the area that gives blood from the nose. Given the anamnestic data, the results of laboratory tests and the data of a general examination of the patient, the doctor will be able to suspect a pathology of a particular body system that provokes nosebleeds, conduct the necessary amount of research and effective treatment that will help the patient avoid such an unpleasant condition as blood from the nose in the future.