What Must I Do About Nasal Bleeding When I Have Upper Respiratory Infection, Loss Of Taste And Mild Mid Septal Deviation?

Posted on Wed, 12 Jan 2022

Question: Hi,
I have just a few hours ago suffered from quite a serious nosebleed which went on for about fifteen minutes and then lessened. It came initially from the left nostril and I think remained only from that nostril although blood did trickle from the right, I don’t think it was from the right nasal canal. The blood for some reason has not trickled down the throat.

I have had a viral upper respiratory infection, some dryness and also discharge from the nose. I have had cough with brown and green sputum which could be coming from the nasal area. I tried to flush out the nasal canal by spraying quite a large amount of saline solution and then blowing the nose hard. The mucus was green and brown, same as from the cough. I did recently lose really any sense of taste although can still taste salt and sweet but not anything subtle.

Could the overuse of the saline spray have caused the nosebleed as salt is crusty and hard when dry? I also tried beconase spray and have taken aerius two days ago.

I have a mild mid septal deviation on the left, what steps should be taken to prevent recurrence of the bleeding? Does coughing risk rebleed and is something like Durotuss ok to take?

Thankyou.

Answered by Dr. Dr. Naveen Kumar Nanjasetty (1 hour later)

Brief Answer:
Acute sinusitis... Avoid nose blowing

Detailed Answer:
Hi

Thanks for posting the query

1. First of all, avoid blowing the nose. During acute infections, the nasal mucosa will be congested and fragile. Hence, even a small amount of trauma such as blowing of the nose can cause rupture of the mucosa and the blood vessels.

2. Secondly, avoid using hypertonic saline. Hypertonic saline causes drying of the nasal mucosa and crusting. Hence, it's always better to use the normal saline nasal spray as frequently as possible.

3. Taste sensations will be less during the episodes of nasal congestion as air doesn't reach the olfactory area of the nose. Hence, the taste will also be compromised.

4. As you have got acute sinusitis, a course of potent antibiotic is a must. Also, you would require a mucolytic such as bromhexine or Ambroxol.

5. Do steam inhalation, drink frequent sips of warm water; avoid smoking/coffee/chilled food and beverages.

Hope this answers your query; I will be available for the follow-up queries.

Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon

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

Follow up: Dr. Dr. Naveen Kumar Nanjasetty (55 minutes later)

Dear Dr.

Thanks for your detailed response. I have follow up queries:

1. Thank you, will follow advice.

2. I used Sterimar Isotonic Solution. Is this hypertonic? If so, which would be a better saline spray to use?

3. Thankyou.

4. Can my sinusitis be caused by a virus? What is the best way to differentiate? I have keflex, doxycycline 5mg and ciproxin on hand. Is any recommended? What would be recommended antibiotic but not penicillin? Noted regarding mucolytic.

5. Is steam inhalation still ok even after serious nosebleed? The hospital advised no hot drinks after nosebleeds, so I am wondering if steam still alright and also warm drinks but not hot.

Also I have a little bit of lightheadedness. Could this be caused by blood loss or more likely linked to the sinusitis?

Just to follow up point 2. I did use the isotonic salt spray but there was little remaining in the can which may have affected concentration. The spray unfortunately was also due to expire this month, I am not sure if these factors could have caused a different salt concentration.

Thank you.

Answered by Dr. Dr. Naveen Kumar Nanjasetty (22 minutes later)

Brief Answer:
Continue with Sterimer isotonic solution

Detailed Answer:
Hi

Thanks for writing back

1. Sterimer isotonic nasal spray is perfect, you can continue using the same.

2. At this stage, it's a bacterial infection. Hence, you would require a potent antibiotic. Keflex can be tried safely.

3. No issues, you can avoid steam inhalation. But, drink frequent sips of lukewarm water. Lukewarm water increases the blood circulation and reduces the congestion. We need to treat the cause of your problem. Hence, warm liquids are safe at this juncture.

4. Lightheadedness is due to blood loss. Keep yourself well hydrated by drinking frequent sips of warm water.

Hope this clarifies your doubts. Wish you good health.

Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon

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

Follow up: Dr. Dr. Naveen Kumar Nanjasetty (21 minutes later)

Dear Dr.

Thanks for the follow-up. I will follow advice and see GP for antibiotic prescription.

I will keep discussion open for now in case of any issues developing.

Thank you.

Answered by Dr. Dr. Naveen Kumar Nanjasetty (22 minutes later)

Brief Answer:
I would be glad to help you at any point in time...

Detailed Answer:
Hi

Welcome back

I would be glad to help you at any point in time. Wish you good health and speedy recovery.

Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon

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

Follow up: Dr. Dr. Naveen Kumar Nanjasetty (42 hours later)

Dr Dr. XXXXXXX

Just by way of update I went see a GP yesterday due to excessive mucus. I was prescribed rulide for five days.

I was not prescribed a mucolytic but have Mentopin on hand. Would this be appropriate to use?

Also I had a tablet of relied at noon, then 7pm yesterday which seemed to clear up the mucus to an almost white clear color but then took the next tablet at 11am the next morning by which time the mucus was again very green and thick. Should I aim to take it very close to bedtime as there is no opportunity to clear mucus during the night which might give the bacteria opportunity to multiply?

Also I had slight bleed in the nose yesterday again but it was well under control compared to the first time. Should I expect more frequent nosebleeds after this incident or would the nasal area normally heal fully?

For mucolytics, can they reduce coughing due to easier expulsion of phlegm?

Thanks.

Answered by Dr. Dr. Naveen Kumar Nanjasetty (30 hours later)

Brief Answer:
Rulide can be continued as suggested by your doctor.

Detailed Answer:

Hi,

1. Rulide can be continued as per the suggestions of the doctor. This helps in controlling the infection. Greenish mucus implies bacterial infection, hence, Rulide would be highly beneficial.

2. Mentopin is also a mucolytic, you can safely use it. If it is a 200mg tablet then you need to take 3 times a day. If it is a 600mg tablet, then, once a day dosage is sufficient. The tablet should be preferably taken after food.

3. Do not worry! With the above medications, you will start feeling better. Use saline nasal spray as and when required. Drink frequent sips of warm water, this would prevent re-bleeding.

Hope this clarifies your doubts. Wish you good health.

Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon

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. Prasad