NOSEBLEEDS

What causes nosebleeds?

Most bleeding from the nose comes from a collection of tiny blood vessels on either side of the cartilage that make up the central wall of the nose. Most of us have had a nosebleed at some stage, but the bleeding usually stops easily after a few minutes. The most common cause of a nosebleed is an injury or picking the nose. Some people, however, may have an underlying problem that causes the bleeding. High blood pressure, infections in the nose, sinusitis, allergic rhinitis, drying of the inside of the nose (for example, in winter), hardening of the arteries and bleeding tendencies (such as leukaemia and liver problems) can all cause bleeding that does not easily stop.

How can I help myself?

• The first thing to do is apply pressure. Pinch the soft part of the nose just below the bony bridge forcefully between finger and thumb and hold in that position for about ten to 15 minutes. Sit forward and breathe through your mouth. This helps a clot to form;
• Plug the bleeding side with cotton wool or plain gauze soaked in white vinegar. The acid in the vinegar gently seals the bleeding vessels together;
• Try an ice pack - put a bag of frozen peas in a damp cloth over your nose while pinching it. The cold encourages the blood vessels to narrow and reduces bleeding;
• Do not pick your nose. It takes seven to ten days to completely heal the torn blood vessels. If you pick your nose you will peel the scab off and cause another nosebleed;
• Cut down on smoking. Smoking dries out the nasal membranes which makes the blood vessels in them more prone to bleeding. Stopping smoking will keep them moist;
• If you are prone to regular nosebleeds it may be wise to avoid aspirin which thins the blood. If you need to take it regularly, discuss the situation with your GP.

When should I see my GP?

If the bleeding has not settled after ten to 15 minutes of applying pressure, or restarts after a few minutes of stopping, contact your doctor. If you can still taste blood at the back of your throat, or are spitting out blood clots after trying to stop the bleeding, you should also contact a doctor. GPs sometimes advise patients to go straight to their nearest accident and emergency department which will have full facilities to deal with bad nose bleeds. If you have any of the medical conditions mentioned above - high blood pressure, sinusitis, allergic rhinitis, a tendency to bleed - and your nose starts to bleed heavily, you should also contact a doctor. The doctor will want to know what you are suffering from and what medication you are taking.

What can my GP do?

• Your GP can prescribe antibiotic ointment which treats infections in the nose that may cause bleeding;
• Your GP can also attempt to cauterise the bleeding area with a chemical stick that burns the blood vessels and seals them shut;
• If the bleeding does not stop your GP may send you to hospital to have the nose packed with gauze. The pressure of the gauze stops the bleeding and allows a blood clot to form;
• Your GP may want to arrange further tests to see why you are getting regular nose bleeds.