Epistaxis

Causes of Epistaxis can be local or general. Local Causes: Injury or trauma, Picking the nose, Foreign bodies in the nose, Nasal Diphtheria, New growths such as Polypus or Malignant tumor e.g. Carcinoma of Nasopharynx, Lupus, Syphilis, Talengiectasis (dilatation of the capillaries on a body surface), A fractured base or depressed fracture of a zygomatic bone or a Pituitary tumor. General Causes: It may be associated with Hypertension, Mitral Stenosis, Portal Cirrhosis of the Liver, Enteric Fever, Whooping Cough, Blood diseases such as Leukemia, Anemia, Hemophilia, and Purpura, etc. and Lowered Atmospheric Pressure such as occurs at High Altitudes. Epistaxis may occur at Puberty without any apparent cause. Otherwise, Excessive Heat in general especially in Summers also considered a cause of Epistaxis where no other cause is perceptible or visualized. Epistaxis may occur in a case of carcinoma of the nasopharynx.

Blood which passes backwards from the nose may be coughed up and appear as haemoptysis. A careful examination of the nasopharyngeal area may reveal the bleeding point. In other cases the blood may be swallowed and vomited and appear as Haemetamasis or passed with stool and look like Malaena. Bleeding usually stops in a short time , but it may be persistent and cause anaemia and debility.

Management varies with the cause of epistaxis. In children, the bleeding usually stops on its own unless due to a foreign body, for which the removal is must. In other cases, a cold compress may be applied to the nose with the patient lying down, or Plugging may be done in which a little cotton wool is inserted into the nostril and pressure applied over it. The cotton may be soaked in Callendulla Millelifolium or Ficus Religiosa or Hamamellis or Trillium Q. Epistaxis associated with a case of hypertension is a useful safety valve and does not require to be checked, unless very excessive.