Epistaxis (Nose Bleed), A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions

This book describes Epistaxis, Diagnosis and Treatment and Related Diseases

A Nose bleeds easily because it is very vascular
The blood vessels are very thin and superficial
They can be damaged easily by injury or sneezing
Rarely is a nose bleed dangerous or life threatening

Most nose bleeds are mild and nose pressure can stop the flow
The rare dangerous nose bleed comes from the upper posterior nose
Where the blood usually drips down the throat and can start choking
Blood thinners can cause dilution of blood and bleeding

Bleeding can also occur from injury to nose and the brain
Avoid smoking which cause irritation to nasal mucosa and vein
Alcohol cause dilation of blood vessels and increase the blood pressure
Avoid foreign bodies in the nose and nose picking for pleasure

If simple pressure do not stop the nose bleeding
The doctor has to put gauze in nose and start nose packing
Bleeding can be stopped with silver nitrate cauterization
Or cryosurgery to make the blood vessels frozen

-An original poem by Kenneth Kee

This week I had a patient who has suddenly sneezed out blood in the yellow mucus from his nose.
This persisted for a few days.
His wife and mother were worried.
Being educated he went to consult an ENT surgeon to examine the cause of bleeding from his nose.
An MRI of his nose showed pus discharge present in the left maxillary sinus.
There was no evidence of any malignancy.
He was reassured by the ENT surgeon and told that it was merely an infection that causes the bleeding.
He was given a course of strong antibiotic and antihistamine.
The bleeding from the nose did not stop so he decided to see me.
Since nothing was given to stop bleeding, in addition to his medicine I gave him some pseudoephedrine which is a blood vessel constrictive.
The bleeding stopped but the yellow mucus persisted so I advised to have a washout of his sinuses to clear the pus.
He saw another ENT surgeon who agreed to do an operation of his sinuses to remove the pus.
He developed the sensation of dizziness which occurred after the operation on his sinuses to remove bloody pus.
He felt the dizziness worse when moving from the lying to the upright position.
Whether it was the after effect of the anesthesia or the operation itself, he was certainly paler than usual and feeling tired.
He was told to return to his ear-nose and throat surgeon for a review including X-ray of his sinuses and a full blood count.
His blood tests showed evidence of mild anemia (low hemoglobin) and low red blood cells count possibly from the loss of blood from the sinusitis and during the operation.
He was told to take Iron with folic acid and multivitamins to build up his blood, stemetil (prochlorperazine) for his dizziness and told to have adequate rest and eat more red meat.
In the meantime his MRI showed evidence of mucosal thickening of the sinus walls and evidence of mild infection.
An antibiotic gel was inserted into his sinuses to try to clear the sinus infection.
In spite of all these measures he still felt dizzy but not as bad as previously.
Since there was no evidence of malignancy, I tried to reassure him and not to worry too much as stress and worry by itself can cause the dizziness.
At this present moment he has stopped bleeding from his nose but is still feeling weak and giddy.

A Nosebleed is said to have happened when the nose starts to bleed from the inner mucosa or lining of the nose.
Nose bleeds are fairly frequent particularly in children.
The medical name is epistaxis.
When a nose bleed occurs, blood flows from one nostril or occasionally both nostrils.
It can be heavy or light and persist from a few seconds to 0 minutes.
Most nosebleeds are minor and normally stop spontaneously.

TABLE OF CONTENT
Introduction
Chapter 1 Epistaxis
Chapter 2 Causes
Chapter 3 Symptoms
Chapter 4 Diagnosis
Chapter 5 Treatment
Chapter 6 Prognosis
Chapter 7 Hematemesis
Chapter 8 Nose Cancer
Epilogue