Epistaxis, which is also known as a nosebleed, is blood loss through tissue in the nose. Bleeding from the nose is a common occurence, although it can be frightening even in the normal situation where it is not life-threatening. There are two classes of epistaxis, which are anterior and posterior. The anterior version is more common, while posterior occurs less frequently while having a greater rate of requiring medical assistance.

Causes

Nosebleeds may be caused by a variety of reasons, including the following:

Alcohol (by vasodilation)
Allergic rhinitis (hay fever)
Allergies
Barotrauma - tissue damage caused by pressure differences
Bleeding disorders
Broken nose
Chemical irritation
Common cold
Deviated septum
Envenomation
Extremely cold air
Extremely dry air
Extremely hard nose-blowing
Hereditary hemorrhagic telangiectasia (HHT)
High blood pressure (hypertension)
Infectious diseases
Nasal blockage
Nose injury
Nose picking
Overdose or large doses of blood-thinning medicine (such as aspirin)
Overuse of decongestant nasal sprays
Repeated sneezing
Sinusitis - inflammation of the sinuses
Stuck object in nose
Surgery (nose, face)
Upper respiratory tract infection
von Willebrand's disease

Diagnosis

Epistaxis is diagnosed by a doctor or medical professional. A physical examination may be performed, including tests such as: complete blood count, nasal endoscopy, partial thromboplastin time (PTT), prothrombin time (PT), and skull x-rays. The doctor may also ask questions about the patient's nosebleeds and other circumstances. The individual may in some cases be carefully watched for symptoms of hypovolemic shock, a condition in which there is a significant loss of blood volume. If hypovolemia advances far enough, then it may become a life-threatening condition which requires assistance from medical personnel.

Treatment

Treatment typically is focused on the underlying cause behind the bleeding nose. For this reason, the diagnosis should be made prior to any condition-specific treatment (general treatment may come at any time, particularly if the patient is in a condition requiring it). Some options include:

Assistance from an ear, nose and throat (ENT) specialist
Blood pressure control
Blood vessel closure
Direct pressure to promote blood clotting
Nasal packing
Nasal sprays in the case of allergic rhinitis
Reducing a broken nose
Reducing or stopping blood-thinner use
Removing a foreign object