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What Causes Constant Nose Bleeds During Night In An Autistic Teenager?

Posted on Thu, 24 Dec 2015

Question: I have a 14 year old autistic son. He is for the most part non-verbal. He is constantly getting nose bleeds only in his right nostril. Sometimes they are minor, but other times they are major. Since school has started 3 months ago, he has had at least 50 nose bleeds in all, at home and at school. Just last night he had a nose bleed that was a real gusher. It took over 15 minutes to get it to stop. We have taken him to seen an ENT, but because of his autism my son will not let the ENT inspect his nose. The ENT suggest it to be cauterize. However we concerned abut the post op care. We are positive that our son will not leave his nose alone after the cauterization. What do you suggest we can do? Is there any other medical procedure available that will help resolve this problem?

Answered by Dr. Krunal Karade (43 minutes later)

Brief Answer:
Your son are most probably having allergic rhinitis result into itching.

Detailed Answer:
Hi,
Thanks for the query.

I have read your query , reviewed your medications and understand your concern.

After reading your clinical history it appears that your son are most probably having allergic rhinitis which causes itching & inflammation into nose & result into nose bleeds .
Investigation needed X ray Nasophaynx lateral view to rule out adenoid enlargement .

I would advice medical management first to control nose bleed .

If I were your treating doctor , I would advice
Saline nasal spray or rinse thrice daily for crust removal ,
Combination Steroid nasal spray with antihistamine 1 puff each nostril twice daily like Duonase nasal spray to decrease inflammation & allergy ,
Tab Vitamin C twice daily ,
Injection Vitamin K to increase blood clotting &
Multivitamin Multiminerals antioxidants syrup twice daily like Vitasure .

Also cut his all nails regularly to avoid nails trauma inside nose while cleaning or itching nose .

You will get relief .

Hope this information helpful to you .If you have any further questions I will be happy to help.

Regards.

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Krunal Karade (5 hours later)

If we decided to have our son's nose cauterized, he will have to be under anesthesia. We can do that. However we are concerned about the post op care. How long is the post op care as far as the healing and care? What if he is uncomfortable with his nose from the procedure and happens to rub it or something else? If he does something to causing the bleeding to reoccur, would that bleeding be worse than if we did not cauterize?

Answered by Dr. Krunal Karade (1 hour later)

Brief Answer:
Your ENT Doctor first examine his nose with endoscope to see bleeding point

Detailed Answer:
Thanks for the follow up query.

Under anesthesia , your ENT Doctor first examine his nose with endoscope , to see any source of bleeding . If any specific bleeding tissue or polyp is seen then he will cauterize that tissue & keep nose packing for 24-48 hours .

For nose cauterization , he will need anesthesia .

In post op care , you need to use Saline nasal spray or rinse thrice daily for 5-7 days .

Even if he rub his nose , bleeding will be less compare to present without cauterization & only for less than 7 days before healing .

Hope this information helpful to you .

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. Arnab Banerjee