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Epistaxis (Nosebleed)

Acute bleeding from the nasal cavity ranging from minor anterior bleeds to life-threatening posterior hemorrhage.

Written by: Saygı Hospital Health Guide Editorial Board
Published:

This content is for general information; please consult your physician for diagnosis and treatment.

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What is Epistaxis (Nosebleed)?

Anterior epistaxis typically arises from Kiesselbach plexus on the anteroinferior septum and accounts for most cases.

Posterior epistaxis originates from the sphenopalatine artery or its branches, is less common, and tends to produce heavier, bilateral bleeding, especially in older or hypertensive patients.

Underlying factors include dry nasal mucosa, trauma, anticoagulation, hypertension, nasal deformity, neoplasms, or hematologic disorders.

Management follows a stepwise algorithm: compression, topical vasoconstrictors, cautery, anterior or posterior packing, and endoscopic or embolic treatment.

Symptoms

Unilateral or bilateral bleeding from the nose
Trickling of blood into the throat and coughing up blood
Lightheadedness, weakness, or hypotension in severe cases
Nasal obstruction from clots
Recurrent mild bleeding in dry climates
Bruising or bleeding elsewhere in systemic disease

Risk Factors

Dry indoor heating and low humidity
Digital trauma, nose picking, and foreign bodies
Anticoagulant and antiplatelet therapy
Uncontrolled hypertension and cardiovascular disease
Nasal tumors, juvenile angiofibroma, or hereditary hemorrhagic telangiectasia
Coagulopathies and thrombocytopenia

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Bleeding that does not stop after 20 minutes of firm compression
  • Heavy posterior bleeding, faintness, or syncope
  • Recurrent or bilateral epistaxis, especially on anticoagulation

Treatment Methods

01
Sit upright, lean forward, and apply firm compression to the cartilaginous nasal dorsum for 10–15 minutes
02
Topical vasoconstrictors (oxymetazoline) and nasal moisturization with saline or emollients
03
Silver nitrate or electrocautery of identified anterior bleeding points
04
Anterior nasal packing with absorbable or non-absorbable material
05
Posterior packing or balloon tamponade for posterior epistaxis with admission and airway monitoring
06
Endoscopic sphenopalatine artery ligation or embolization for refractory posterior bleeding

Which Department to Visit?

You can visit our KBB (Kulak Burun Boğaz) department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About KBB (Kulak Burun Boğaz) Department

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.