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Suggest Treatment For Symptoms Of Anterior Epistaxis
Question: Hi,
I’m concerned about the possibility of having posterior epistaxis. I realize this is quite rare and probably pretty unlikely but I have OCD and frequently worry about medical problems.
About 6 hours ago I had a nosebleed. It happened immediately after I blew my nose. It was isolated to the left nostril only and after 40 minutes of compression it stopped bleeding. I’ve never had a nosebleed where I lost this much blood. I estimate it was about 40-60 mL.
When I was younger I used to have nosebleeds frequently about 1-2 a week until I got my nose cauterized.
They stopped around the time I was 12 years old.
Since then I would maybe have 1-2 every year if that.
This past year (2014) I’ve had maybe about 4-5.
I do not have a history of hypertension. But I get nervous / anxiety a lot cause of the OCD so my BP sometimes get’s elevated.
I do not have any blood conditions that I know of....hypercoagulability or hypocoagulability
The only medicine I’m currently regularly taking is 5mg of propranolol twice a day for anxiety and a multivitamin. The Multivitamin is from a compounding pharmacy (bellevuerx.com) and contains forms of vitamins that are more easily absorbable then traditional over the counter vitamins. It contains some of the following:
methycobalamin (active form of b12): 2mg
pyridoxal-5-phosphate (active form of b16): 25mg
5-methyltetrahydrofolate (active form of folic acid): 7.5mg
zinc acetate dihydrate (zinc): 10mg
magnesium glycinate (magnesium): 400mg
the list is pretty extensive but basically it’s just the active form of vitamins.
What concerns me is since this happened I’ve had a very slight taste of blood in the back of my throat and what feels like post nasal drip on the left side where the nosebleed happened. My blood pressure has been normal all day. I’ve felt a bit light headed but this could be from anxiety or small dose of propranolol. I’ve had what feels like a sinus headache all day.
around 11:00pm yesterday I took 400mg of ibuprofen for a back ache.
at 10:00am I took 5mg of propranolol and my vitamin
the nosebleed happened at 11:30am this morning
I drank 24oz of 5% alcohol beer with lunch at around 1:25pm
Do you think it’s possible I have a serious posterior nosebleed? I’ve been a bit nauseous on and off…primarily right after the nosebleed. I could feel blood going down my throat when I was applying pressure to me nose. I have not been coughing up / spitting up blood or vomiting blood.
Do you think it's possible i'm having a posterior nosebleed and blood is draining down my throat?
I’m concerned about the possibility of having posterior epistaxis. I realize this is quite rare and probably pretty unlikely but I have OCD and frequently worry about medical problems.
About 6 hours ago I had a nosebleed. It happened immediately after I blew my nose. It was isolated to the left nostril only and after 40 minutes of compression it stopped bleeding. I’ve never had a nosebleed where I lost this much blood. I estimate it was about 40-60 mL.
When I was younger I used to have nosebleeds frequently about 1-2 a week until I got my nose cauterized.
They stopped around the time I was 12 years old.
Since then I would maybe have 1-2 every year if that.
This past year (2014) I’ve had maybe about 4-5.
I do not have a history of hypertension. But I get nervous / anxiety a lot cause of the OCD so my BP sometimes get’s elevated.
I do not have any blood conditions that I know of....hypercoagulability or hypocoagulability
The only medicine I’m currently regularly taking is 5mg of propranolol twice a day for anxiety and a multivitamin. The Multivitamin is from a compounding pharmacy (bellevuerx.com) and contains forms of vitamins that are more easily absorbable then traditional over the counter vitamins. It contains some of the following:
methycobalamin (active form of b12): 2mg
pyridoxal-5-phosphate (active form of b16): 25mg
5-methyltetrahydrofolate (active form of folic acid): 7.5mg
zinc acetate dihydrate (zinc): 10mg
magnesium glycinate (magnesium): 400mg
the list is pretty extensive but basically it’s just the active form of vitamins.
What concerns me is since this happened I’ve had a very slight taste of blood in the back of my throat and what feels like post nasal drip on the left side where the nosebleed happened. My blood pressure has been normal all day. I’ve felt a bit light headed but this could be from anxiety or small dose of propranolol. I’ve had what feels like a sinus headache all day.
around 11:00pm yesterday I took 400mg of ibuprofen for a back ache.
at 10:00am I took 5mg of propranolol and my vitamin
the nosebleed happened at 11:30am this morning
I drank 24oz of 5% alcohol beer with lunch at around 1:25pm
Do you think it’s possible I have a serious posterior nosebleed? I’ve been a bit nauseous on and off…primarily right after the nosebleed. I could feel blood going down my throat when I was applying pressure to me nose. I have not been coughing up / spitting up blood or vomiting blood.
Do you think it's possible i'm having a posterior nosebleed and blood is draining down my throat?
Brief Answer:
Anterior epistaxis more likely.
Detailed Answer:
Hi,
Thank you for your query.
1. From your description, an anterior epistaxis is more likely.
2. Any epistaxis should be dealt with by an ENT Specialist. A nasal endoscopy, a CT Scan, nasal packing, cautery and blood tests help in identifying the source. For example the hemoglobin level will indicate if the bleeding is severe or not.
3. The nose has such abundant blood supply that it can bleed like a garden hose. Hence 40-60 ml is a fairly small quantity but can herald a more severe bleed in the future. Hence I would urge you to get this examined and investigated.
I hope that I have answered your query. If you have any more questions I will be available to answer them.
Regards.
Anterior epistaxis more likely.
Detailed Answer:
Hi,
Thank you for your query.
1. From your description, an anterior epistaxis is more likely.
2. Any epistaxis should be dealt with by an ENT Specialist. A nasal endoscopy, a CT Scan, nasal packing, cautery and blood tests help in identifying the source. For example the hemoglobin level will indicate if the bleeding is severe or not.
3. The nose has such abundant blood supply that it can bleed like a garden hose. Hence 40-60 ml is a fairly small quantity but can herald a more severe bleed in the future. Hence I would urge you to get this examined and investigated.
I hope that I have answered your query. If you have any more questions I will be available to answer them.
Regards.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
the post nasal drip i seem to be getting on the left side has slight taste of blood. The left side is the same side the nose bleed happened on. Is it possible that even though I stopped the blood from coming out of my nose from just using compression that it could still be bleeding slightly down the back of my throat?
oh i forgot to mention, I haven't been coughing up blood or vomiting blood and tried to cough up some of the post nasal stuff but it's all clear in color... I smell or taste a little bit of blood in the back of my throat. It worries me.
oh i forgot to mention, I haven't been coughing up blood or vomiting blood and tried to cough up some of the post nasal stuff but it's all clear in color... I smell or taste a little bit of blood in the back of my throat. It worries me.
Brief Answer:
No, a post nasal bleed cannot go unnoticed.
Detailed Answer:
Hi,
Thank you for writing back.
1. No, a post nasal bleed cannot go unnoticed. You will either be able to cough it out or swallow it.
2. If a large amount of blood is swallowed, it invariably leads to gastritis and vomiting. There will also be a sudden fall in the hemoglobin levels.
3. You do not have coughing nor vomiting, so this is a good indicator that the bleeding is minimal.
4. The smell and taste of a little blood at the back of the throat will alo be due to gravity and active nasal muco-ciliary clearance.
5. Your ENT Specialist will look for any post nasal blood clot, blood stain or active trickle.
6. Posterior nasal bleeds do not stop with anterior compression. From your description this is probably a venous bleed. Get examined while the bleeding has stopped. This will make treatment easier.
I hope that I have answered your query. If you have any more questions I will be available to answer them.
Regards.
No, a post nasal bleed cannot go unnoticed.
Detailed Answer:
Hi,
Thank you for writing back.
1. No, a post nasal bleed cannot go unnoticed. You will either be able to cough it out or swallow it.
2. If a large amount of blood is swallowed, it invariably leads to gastritis and vomiting. There will also be a sudden fall in the hemoglobin levels.
3. You do not have coughing nor vomiting, so this is a good indicator that the bleeding is minimal.
4. The smell and taste of a little blood at the back of the throat will alo be due to gravity and active nasal muco-ciliary clearance.
5. Your ENT Specialist will look for any post nasal blood clot, blood stain or active trickle.
6. Posterior nasal bleeds do not stop with anterior compression. From your description this is probably a venous bleed. Get examined while the bleeding has stopped. This will make treatment easier.
I hope that I have answered your query. If you have any more questions I will be available to answer them.
Regards.
Note: Consult an experienced Otolaryngologist / ENT Specialist online for further follow up on ear, nose, and throat issues - Book a Call now.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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