Topic Overview
Nosebleed, also known as epistaxis, occurs as a result of damage to the blood vessels within the nose. The damage causes blood to flow out of the nose. Nosebleeds can either be posterior or anterior depending on the area where the blood vessel damage occurs. In cases of a posterior nosebleed, blood flows out of the back of the nasal cavity. The blood flow in Posterior Nosebleed is much heavier when compared to anterior nosebleeds.[2]
Nosebleed is a common occurrence and it is estimated that about 60% of people across the world experience this at time point in their lives. However, as little as 5-6% actually require treatment for it. In a case study conducted studying Posterior Nosebleeds, around 100 people were studied with an average age of 60 years. All these participants had a history of being treated in the emergency room for nosebleeds. The study revealed that the common factors that contributed to posterior nosebleeds were hypertension which was seen in about 45% of the participants.[1]
A history of a previous episode of nosebleed was also believed to be one of the causative factors for posterior nosebleeds with approximately 60% participants having this history. Another 60% had nasal hemorrhage for less than 12 hours before they went to the emergency department. Around 20% of the participants were those who had bleeding for more than 24 hours before they went to the emergency department. About 88% of people with posterior nosebleeds reported that the bleeding was quite severe in nature. Read below to know about the different causes and ways to manage posterior nosebleeds.[1]
What Causes Posterior Nosebleed?
Some of the common causes for posterior nosebleeds include
Irritation: People who continuously prick on their noses or blow the nose vigorously can have posterior nosebleeds. In some cases, inhalation of chemicals like ammonia also results in the individual having Posterior Nosebleed. There are also instances where prolonged exposure to dry air is known to cause this condition. People who undergo surgery to the nose or the head also have at times nosebleeds that may be posterior in nature.[2]
Medical Conditions: There are also certain medical conditions that cause Posterior Nosebleeds. Hypertension and calcium deficiency are the most common medical conditions that cause Posterior Nosebleeds. People who have hemophilia or leukemia are also at risk for having frequent posterior nosebleeds. People with autoimmune conditions or inflammatory disorders also at times experience posterior nosebleeds. Atherosclerosis is yet another medical condition believed to cause posterior nosebleed.[2]
Medications: There are also some medications that can cause an individual to have posterior nosebleeds. These generally are antihypertensives, blood thinners, or anti inflammatory medications. Some of these medications include aspirin and warfarin. Additionally, Gingko Biloba and vitamin E supplements also carry a risk of causing Posterior nosebleeds.[2]
How To Stop Posterior Nosebleed?
As soon as a posterior nosebleed starts, the first step towards treatment is to hold the nose so that some pressure is put and the bleeding is controlled. Nasal decongestants can also be used to stop the bleeding. There are some common steps that one can take to stop Posterior Nosebleed. This includes sitting straight and upright and keep the head straight. The person can lean just a little bit forwards to prevent the blood from entering the throat. One can also gently blow the nose so that any clots present within it can be eliminated.[2]
Once the bleeding stops, the person can place a bag of ice on the nose to calm down the swelling and pain. It should be noted here that after the nosebleed stops it is mandatory to stay away from common irritants like cigarette smoke and not to blow or prick at the nose for a few hours. In case of Posterior Nosebleeds further medical treatment is mandatory. These treatments include.[2]
Nose Packs: As soon as the patient presents to the emergency room with a Posterior Nosebleed, the posterior area of the nose will be packed with cotton gauze. There will also be pressure put on the area of bleeding by way of nasal sponge to stop the bleeding.[2]
Cauterization: This can be electrical or chemical and is quite effective for people with Posterior Nosebleeds. This is done when the pressure applied on the nose alone does not stop the bleeding. The technique utilizes laser beams or chemical normally silver nitrate to burn the damaged vessel and stop the bleeding.[2]
Surgical Ligation: This process involves ligation or clipping of the vessel or artery from bleeding occurs. This procedure is done when all other measures to stop the nosebleed fail.[2]
In most cases, medical treatment is not required for nosebleeds but if they tend to occur frequently or if the bleeding is heavy then treatment will be required to stop the bleeding.[2]
In conclusion, Nosebleeds are quite common and benign. They neither are nor indicate a serious threat to the medical condition. Nosebleeds are categorized into two, namely anterior and posterior. An individual with posterior nosebleed will have bleeding from the back of the nasal cavity. The bleeding that occurs posteriorly is heavier and often at times requires medical treatment.[1, 2]
Almost everyone with a posterior nosebleed recover completely without any adverse effects or any long term problems. However, it is always better to get Posterior Nosebleeds treated with a physician so as to prevent any future episodes.[1, 2]
