As a “growing pain” for parents and children themselves, pediatric rhinorrhea is a common disorder in otorhinolaryngology, laryngology, head and neck surgery, whether as an outpatient, especially on weekends and during summer and winter vacations, or as a late-night emergency. Some children bleed a few times occasionally, especially in the spring and fall/winter, or during colds, fevers and upper respiratory infections. Some children repeatedly bleed several times, in more or less amount, or even have inexplicable nosebleeds during sleep without any cause or warning, which often cause panic in children and worry in parents. In fact, most children are prone to rhinorrhea, which is a “minor annoyance in the process of growing up”, or will heal on its own without treatment, so there is no need to panic and worry, only a few need active treatment.
First of all, most pediatric rhinorrhea is caused by certain anatomical and life habits. The nasal mucosa of children is particularly thin, only 1/10 of that of adults, so the vascular network under the anterior nasal septum is relatively shallow and easily bleeds due to inflammation and temperature changes, so pediatric rhinorrhea is mostly under the anterior nasal septum, which is also called the bleeding area. Of course, children like to pick and rub their noses, which can easily damage the mucous membrane and small blood vessels in this area accidentally, resulting in bleeding.
Although this part of the pediatric patient has repeated nasal bleeding, as long as the amount is not large, it is generally not harmful to the body and does not necessarily require special active treatment. Parents should not panic when bleeding, but comfort their children and stabilize their emotions, because the more they cry and quarrel, the more bleeding there is. At the same time, a cotton ball (not too deep) can be filled in the nasal cavity on the bleeding side. If the family has ephedrine nasal drops, the cotton ball can be filled with nasal drops and then the child’s nose can be pinched tightly with the thumb and index finger to stop the bleeding in a few minutes. For larger children, parents can teach the child to stop the bleeding by pinching the nose themselves. Follow up with a little eye ointment to protect the front of the nasal cavity. Only a few children with pulsatile bleeding spots need cautery to stop the bleeding, but it is not effective in preventing the next bleeding.
Therefore, the only way to heal is to wait for the child’s growth and development to gradually heal itself later. Encourage your child to drink more water, eat more cool fruits, keep the bowels open, and control the temperature and humidity in the room during the cold and dry autumn and winter months, as it is easy to bleed if it is too hot or too dry. Foods such as red dates, cinnamon and chocolate can easily cause nosebleeds. Children with rhinitis and sinusitis should go to the ENT head and neck surgery clinic for treatment, and the bleeding will improve after the inflammation is controlled and improved.
Secondly, a very small number of children with rhinorrhea have special causes. Such as hematologic (e.g., remittance, leukemia, hemophilia, thrombocytopenic purpura, etc.) and other systemic (e.g., hyperthermia, uremia, those who are taking long-term anticoagulant drugs, etc.) or local diseases cause nasal bleeding. For children with recurrent rhinorrhea, heavy bleeding, or unilateral rhinorrhea, blood, nasal endoscopy or CT examination should be done to exclude hematologic disorders, bleeding tumors in the nasopharynx or nasal cavity, and nasal foreign bodies.
For nasal bleeding due to hematologic and other systemic diseases is generally more difficult to control at home, and requires hospitalization for nasal tamponade to stop bleeding and etiologic treatment, such as inpatient treatment in hematology. For nasal bleeding caused by bleeding tumors in the nasopharynx, nasal cavity, surgical treatment is required. For nasal bleeding caused by foreign body in the nasal cavity, the nasal bleeding is usually cured after removal of the foreign body.