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Nosebleeds/Epistaxis

Epistaxis or “nosebleeds” are very common and can occur for a variety of reasons. The inside lining of the nose is very vascular and has a rich blood supply, with blood vessels located very close to the surface. The vascular membrane that lines the nose can split, breaking a blood vessel, and causing nasal bleeding to occur. Nosebleeds are especially common in the Northeast region due to the dry climate. Installing humidifiers in the house, especially during winter, can reduce the occurrence of nosebleeds.

Most of the time, nosebleeds will resolve on their own. During an active bleed, keeping the head elevated and pinching the front of the nose (like you are diving underwater) for approximately 15-20 minutes will often control the bleeding.

However, when the bleeding is aggressive and persists beyond the above measures, patients should come into the Mass. Eye and Ear Emergency Department to see an ear, nose, and throat specialist. The specialist may need to treat the broken blood vessel to stop the bleeding. Sometimes this is done through chemical cautery, a minor procedure in which the physician slightly burns the area that’s bleeding and allows it to heal by keeping it moist. In some cases, packing the nasal cavity in the emergency room setting will stop the bleeding. If this is not enough, sometimes an operative procedure during which the problematic blood vessel is identified and clipped. In rare cases, embolization is recommended to stop the bleeding, in which a radiologist will perform an angiogram and inject particles into the blood vessels.

If you experience recurrent episodes of brisk bleeding, then you need to be evaluated by an ear, nose and throat doctor. There can be other underlying reasons for recurrent nosebleeds, such as vascular abnormalities or tumors. An endoscopic exam and CT or MRI scan may be needed to further evaluate recurrent episodes of aggressive bleeding.

For more information on nosebleeds, please speak with your physician.