Epistaxis

What Is Epistaxis?

Epistaxis refers to bleeding from the nose and is commonly known as a nosebleed. It may occur from the front of the nose (anterior) or from deeper areas where blood flows toward the back of the throat (posterior). In many cases, nosebleeds are mild and settle with simple measures at home.

However, epistaxis can sometimes signal an underlying issue such as persistent nasal inflammation, sinus infections, structural problems within the nasal passages, or, less commonly, nasal tumours. In Singapore, nosebleeds may also present as one of the early signs of nasopharyngeal cancer in certain individuals.

Nasal and sinus conditions frequently overlap. As seen in sinusitis, factors like chronic congestion, dryness, or irritation may make the nasal lining more prone to bleeding.

What Are The Causes Of Epistaxis (Nosebleeds)?

Multiple factors may contribute to nosebleeds. These include:

– Trauma to the nose (accidental impact or nose-picking)
– Allergies causing recurrent inflammation
– Foreign bodies lodged in the nose
– Low humidity or dryness affecting the nasal lining
– Certain medications such as blood thinners or nasal sprays
– Medical conditions that increase bleeding tendency
– Nasal infections or sinusitis, which may irritate the lining
– Nasal tumours or abnormal growths

As with sinus-related conditions in Singapore’s humid climate, ongoing irritation, environmental triggers, or structural variations may predispose individuals to episodes of epistaxis.

How Do I Manage Epistaxis (Nosebleeds) At Home?

If a nosebleed occurs, you may try the following steps:

– Sit upright and lean slightly forward to avoid swallowing blood.
– Pinch the soft part of both nostrils firmly for 5–10 minutes without releasing.
– Place an ice pack on the forehead or bridge of the nose.
– Suck on ice chips or gargle cold water to encourage the blood vessels to constrict.

Most mild episodes settle with these measures. Avoid lying flat or tilting the head backwards, as this can cause blood to flow into the throat.

When Should I See a Doctor For Epistaxis (Nosebleeds)?

You should consider seeking medical attention if:

– The bleeding does not stop after 10 to 15 minutes of applying firm pressure
– Nosebleeds occur repeatedly over days or weeks
– There is a known family history of nasopharyngeal cancer
– You have a history of smoking
– Bleeding is accompanied by nasal blockage, facial pressure, or symptoms suggesting sinus inflammation
– You notice bleeding after a recent nasal injury

Recurrent episodes may indicate irritation, infection, or structural issues that resemble the persistent patterns seen in chronic sinus conditions. A review helps determine whether further assessment is needed.

What Are the Treatment Options For Epistaxis (Nosebleeds)?

Management depends on the cause and severity of the nosebleed. During your visit, the doctor will first assess for contributing factors such as allergies, sinus inflammation, or environmental triggers.

Treatment may include:

– Medication to manage allergies or nasal inflammation
– Environmental modification such as humidifying the air or reducing exposure to dry environments
– Chemical cautery under local anaesthesia to seal small bleeding vessels
– Electrical cautery using a controlled heat source to close affected vessels
– Surgical intervention in more severe or recurrent cases to tie off deeper vessels

As with sinus conditions, addressing the underlying contributor, whether structural, inflammatory, or environmental, is an important part of long-term management.

Can Epistaxis (Nosebleeds) Be Prevented?

Preventive measures include:

– Treating underlying nasal or sinus conditions early
– Managing allergies with medication where appropriate
– Avoiding overly dry environments when possible
– Using humidifiers at home
– Reducing exposure to irritants, including cigarette smoke

Keeping the nasal lining healthy and well-moisturised may help reduce the frequency of nosebleeds, similar to how nasal hygiene and allergy control are recommended for individuals with recurrent sinus issues.

Consult an ENT Specialist in Singapore

If your symptoms persist or if nosebleeds occur repeatedly despite home measures, it may be helpful to speak with an ENT specialist for a thorough assessment. Some cases may be linked to nasal irritation, sinus problems, structural narrowing, or underlying medical conditions that require further evaluation.

A consultation can help determine the cause of your symptoms and guide you through the next steps, whether this involves nasal care, medication, or additional investigations.