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What Causes Sudden Occurrence Of Nose Bleeds?

Posted on Mon, 15 Jun 2015

Question: Hi, Dr. Saha. On Saturday night my wife suddenly developed a bleeding nose that dripped down her throat and out her nose. She had no signs that it was coming. She put gauze in her nostril and applied ice, and pushed gauze under her lip. The bleeding stopped after about 15-20 minutes.
What might have been the cause of a sudden nose bleed like that? She never has them.

Answered by Dr. Prof. Kunal Saha (10 minutes later)

Brief Answer:
Nasal polyp or high blood pressure are likely causes.

Detailed Answer:
Thanks for choosing to ask be specifically.

I have gone through the query. Such a bleeding could broadly have three causes:
* Bleeding disorders: NSAIDs reduce the clotting capacity of the blood and could be associated with such bleeding. Otherwise, bleeding disorders could be a cause (unlikely to be the case here).
* Hypertension: Raised blood pressure is more likely to be the cause of such a bleeding. The condition is more likely if she is a known hypertensive. The blood pressure needs to be monitored.
* Nasal polyp or nasal growths could also be a cause of such a bleeding. An ENT evaluation is mandated in such a scenario.

Hope that helps.

Regards
Dr. Kunal Saha

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Prof. Kunal Saha (22 minutes later)

Thank you. She doesn't know of a polyp, but she has a deviated septum. Her blood pressure is actually lower than average. But she does take Advil and Tylenol for the arthritis pain, but not in large amounts. She has only been taking Benadryl lately for several days. The nose bleed was something brand new.

Answered by Dr. Prof. Kunal Saha (6 minutes later)

Brief Answer:
An ENT consultation is essential. Polyp needs to be ruled out.DNS related.

Detailed Answer:
Thanks for writing back.
The deviated nasal septum (DNS) could be associated. Polyp or some other related cause needs to be ruled out. An ENT consultation is essential. Tylenol would not cause the problem. Advil could but only if taken in reasonable amounts.
Regards

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Prof. Kunal Saha (12 minutes later)

Dr. Saha, my wife just found this report from a number of years ago. It is attached.

Answered by Dr. Prof. Kunal Saha (7 minutes later)

Brief Answer:
The reports confirm my suspicion

Detailed Answer:
Thanks for the reports. They confirm my suspicion. An ENT consultation should take care of the rest. Steam inhalation should be helpful for her in general.

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Prof. Kunal Saha (2 days later)

Hello again, Dr. Saha. Strangely enough, on the same side where my wife had the bleeding nose on Saturday she awoke this morning with swelling around her upper eyelid and some below under her lower eyelid, and she thinks it may be congestion-related. She is trying to get an appointment with an ENT but I wanted to send you the photo to take a look and tell me your opinion. It is strange, no pain or discomfort or itching.

I have uploaded the pic

Answered by Dr. Prof. Kunal Saha (7 hours later)

Brief Answer:
The nasal pathology is causing obstructive symptoms

Detailed Answer:
Thanks for writing back. I have gone through the image. I feel that there is some nasal pathology which is causing obstruction to the flow of the lymphatics draining the area. The lymphatic vessels clear the redundant fluid from tissues, failing which the fluid is getting collected in the surrounding tissues, in particular in the loose tissue around the eye. It correlates with the previous history. You need to wait for the ENT consultation. See if you can hasten the process. Till then steam inhalation a few times a day should be helpful.

Regards

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Prof. Kunal Saha (13 minutes later)

Thank you for your reply. What might be the pathology that caused it suddenly, especially several days after the nose bleed? She may be able to see the ENT on Tuesday morning. She has no pain there but says she feels some congestion.

Answered by Dr. Prof. Kunal Saha (4 hours later)

Brief Answer:
Its hard to comment on the nature of the nasal pathology without examining

Detailed Answer:
It is hard to comment on the nature of the nasal pathology without a proper ENT evaluation. Tuesday is reasonable for the appointment. Steam inhalation should provide relief in case of congestion.

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