Nosebleeds, medically known as epistaxis, are mostly caused by “lung dryness and blood heat”, resulting in dryness of the nasal cavity and rupture of capillaries due to insufficient toughness. If left untreated and prolonged, it will have serious and life-threatening consequences. Those who have sudden nosebleeds without warning must go to the hospital for a checkup to rule out nasal tumors and other lesions as early as possible.
Reasons behind the bleeding
The causes of nosebleeds can be roughly divided into two types, one is the more common cause, that is, the nose itself caused by disease, and the other is caused by systemic diseases.
Bleeding from the nose itself is most commonly caused by dryness or erosion of the nasal mucosa. This often happens when the weather is excessively dry or after eating chili, beef and mutton and a small amount of nose bleeding occurs. Some people have the bad habit of digging their nose, and some people blow their nose especially hard, these actions can also damage the small blood vessels of the nasal mucosa, and cause nasal bleeding phenomenon. In addition, if the nasal septum (the interval between the two nostrils) deviates from the midline, bends significantly, or even bulges partially, then this protruding part is more likely to bleed.
In addition, inflammation or fungal disease in the sinuses can also trigger nasal bleeding. It is worth to be alerted that when there is a hemangioma in the nose, nasal bleeding is often higher; and malignant tumors such as nasal cavity cancer or nasopharyngeal cancer also often show blood in the nose in the early stage.
Of course, some systemic diseases can also show nose bleeding, for example, diseases causing fever can bleed due to nasal mucous membrane congestion, and blood diseases such as thrombocytopenia or leukemia can cause nose bleeding due to abnormal blood clotting function. Severe liver impairment may also cause nose bleeding due to coagulation disorders.
The following tests should be done for nosebleeds
1.Visit medical history Those who have severe nasal bleeding often have blood on both sides, so it is necessary to understand the side that bleeds first through medical history and that side is the bleeding nasal cavity, and it is also necessary to understand the major related diseases in the past.
2, quickly find the location of bleeding, with 0, 1% epinephrine cotton tablets containing 0, 1% epinephrine placed in the bleeding nasal cavity, a minute later removed, under the nasal cavity to find the bleeding site.
3.How to find out the site of nasal bleeding method introduced.
(1) Below the anterior nasal septum: there are branches from the anterior sieve artery, nasopalatine artery and superior labial artery in the nasal mucosa, which anastomose with each other in the superficial mucosa to form a mesh.
(2) Anterior base of nasal septum: If there is pulsatile bleeding at this site, use a finger to compress the upper lip on that side. If the bleeding decreases or stops, it indicates a rupture of the nasoseptal branch of the superior labial artery, and ligation of the superior labial artery must be considered for treatment.
(3) Top of the nasal cavity: the top of the nasal cavity should be examined in the case of head and facial trauma. The anterior septal artery travels in the airspace of the septal sinus, and severe bleeding can occur in the event of a septal sinus fracture.
(4) If severe nasal bleeding occurs several days after head trauma, the patient should be checked for visual acuity and ocular muscle function and alerted to pseudoaneurysm formed by fracture of the middle cranial fossa and rupture of internal carotid artery.
(5) Nasal endoscopy: If the bleeding occurs behind the deviated nasal septum, the posterior edge of the nasal septum, the posterior middle turbinate, the anterior and posterior ends of the inferior turbinate and the nasal floor and nasal biscuit, the exact bleeding site can be found with the help of nasal endoscopy.
Accurate judgment and proper first aid
Once nasal bleeding occurs, first aid measures should be taken promptly. If the nasal bleeding is caused by dryness or erosion of nasal mucosa, you should pay attention to your eating habits and increase the humidity of the room in general. When there is blood in the nose, nasal odor and blockage, it may be caused by serious sinusitis or fungal infection, so you can go to a specialized hospital for a clear diagnosis and timely treatment. If a person with nasal bleeding feels that nasal congestion is getting heavier and heavier, or even has headache, double vision, protruding eyes, stuffy ears and lymph nodes in the head and neck, this may be a sign of malignant tumor, which requires further detailed examination in hospital to avoid delaying treatment.
Generally speaking, the possibility of nasopharyngeal carcinoma should be thought of if the following conditions occur, and timely medical treatment should be sought in a specialized oncology hospital.
1.Blocking of the eustachian tube by the tumor can cause tinnitus, ear stuffiness and hearing loss on that side. Any unexplained tinnitus, ear stuffiness, ear pain or deafness, especially if it develops in one ear, the symptoms progress faster and the general treatment is ineffective.
2. Cervical lymph node metastasis is the early symptom of nasopharyngeal carcinoma, which can reach more than 80%. The enlarged lymph nodes are painless, hard, poorly mobile, gradually and rapidly enlarged and fixed, and multiple enlarged lymph nodes may fuse with each other to form a huge mass, and the treatment effect is not effective according to inflammation or tuberculosis.
3.Patients with lateral catarrhal otitis media, especially with more fluid in the middle ear cavity, do not improve significantly after timely and reasonable treatment, and the symptoms continue to worsen.
4.Nasal congestion: This is another early manifestation of nasopharyngeal carcinoma, mostly unilateral, and the nasal congestion is mostly unrelated to body position, which is persistent and progressively aggravated. When the tumor enlarges, both sides have nasal congestion.
5.Persistent and persistent headache on one side with unknown cause often appears and gradually worsens, which is not relieved by internal pain relief drugs.
6.Anyone with unexplained cranial neuropathy such as limited eye movement, inability to abduct, headache, unfavorable swallowing, hoarseness, coughing and choking, weakness of shoulder lifting, etc., especially those with multiple cranial nerve damage manifestations.
7. Symptoms of neighboring organs: early tumor damages skull base and involves trigeminal nerve, which shows pain in top of head, occipital and temporal area, and also shows symptoms such as facial numbness, double vision and blurred vision. If you find any of the above “traces”, you should check them in time.
8.Blood in nasal mucus or blood in sputum after nasal aspiration often occurs in the morning after waking up, and blood in nasal mucus is sucked out from mouth. Since the blood vessels of tumor in nasopharyngeal cavity are brittle and there is often no mucous membrane covering the exterior of tumor, so it is easy to have the symptoms of bloody nasal mucus. Blood in the nose is one of the early symptoms of nasopharyngeal carcinoma, which is often misdiagnosed as respiratory tract inflammation, so it has attracted great attention of patients and their families.