Nosebleeds - When to see the ENT?

Nosebleeds - When to see the ENT?

A nosebleed, or epistaxis, is just as common as it is annoying.  It can happen when you’re at a restaurant. It can happen after a shower.  It can happen while you’re sleeping!  And as the air gets drier in the winter, they tend to be more frequent.

What causes nosebleeds?
Nosebleeds are most commonly caused by small breaks in the lining of your nose, near the front.  This is because there are many small vessels that come together in that region of your nose.  The lining here is very thin, and any trauma (e.g. picking at your nose, sticking tissue in the nose) can make things worse.  However, many nosebleeds are random and not from any one particular traumatic event.  Some infections can lead to nosebleeds and patients will need antibiotics to treat the infection.  Some people have bleeding disorders that are first noticed because they have frequent nosebleeds.

How are nosebleeds treated?
The nose is sensitive and should be treated gently.  If you tend to have nosebleeds, be sure your nose is staying hydrated.  Your doctor is a great resource for regimens on how to prevent nosebleeds as well as stop them while they’re happening.  You’ll want to make sure you know all of your medications and supplements, as some over the counter products can thin your blood.

A variety of products are available including saline (salt-water) sprays and rinses, certain decongestant sprays, ointments, and various types of gauze that help with clotting.

We often try to stop nosebleeds without cauterizing or packing the nose, but sometimes this is required to stop a pesky bleed.  You and your doctor will decide when that is appropriate.  Some patients require antibiotics while they have packing in their nose.

When to see the Otolaryngologist?
If you’re finding that nosebleeds are difficult to stop, or they’re simply very frequent, it’s a good idea to be evaluated to find a source of the bleeding.

One of the biggest concerns we hear about is how much blood might be lost with a nosebleed.  It is extraordinarily rare to have enough blood loss to require a transfusion, and even more rare to have someone bleed to death.  No matter how much blood you notice with an episode, the most important thing is to remain calm.

We can often see patients the same day as a bleed, to help identify and stop the bleeding.

Dr. Oberman sees patients in our North Durham office, located at 4102 N. Roxboro Street, Durham, NC 27704, our South Durham office, located at 5726 Fayetteville Road, Suite 102, Durham, NC 27713 and our Chapel Hill office, located at 55 Vilcom Center Drive, Suite 140 Boyd Hall, Chapel Hill, NC 27514. Call 919-595-2000 to schedule an appointment today.

By: Ben Oberman, MD