Epistaxis (Nosebleed)

Epistaxis (Nosebleed)

Epistaxis (Nosebleed) Causes and Treatment in Singapore

What is Epistaxis?

Nosebleeds or Epistaxis normally occur when a blood vessel bursts in the nasal cavity’s lining in Singapore. As blood vessels are much more fragile in the nose, being in dryer temperatures or facing an increase in air pressure can irritate the skin in the nasal cavity. This causes the blood vessels to rupture and causes you to have a nosebleed.

What causes Epistaxis?

Most Singaporeans experience a nosebleed at least once in their lives. In children, nosebleeds are common when playing sports especially due to a fall or other trauma to the nose. In adults, nosebleeds could be caused by bleeding disorders such as Hemophilia.

Bleeding typically occurs in one nostril. When you experience a nosebleed in both nostrils, it could be a result of a heavy flow form one nostril to the other which leads to a backflow. You may bleed from the mucous membrane near the front of your nose or higher up in the nasal cavity, though this will depend on the cause of the nosebleed.

The severity of a nosebleed can be evaluated by checking if it is short-lived or prolonged. It is important to understand how heavy and frequent the bleeding is and how long it takes to stop.

Some causes of nosebleeds in Singapore may include: 

  • Dry climate
  • Injury to the nose
  • Rhinitis and sinusitis
  • Nasal polyps
  • Deviated nasal septum
  • Frequent exposure to chemical irritants
  • Bleeding disorders
  • Other autoimmune diseases i.e. leukemia

What are symptoms of Epistaxis?

  • Blood coming out of the nose
  • Feeling of liquid dripping behind the throat
  • Dizziness and light-headedness

Is Epistaxis painful?

A nosebleed may be painful if it is caused by an injury to the nose such as in sports or through an accident. Most of the time, there is slight discomfort when experiencing a nosebleed and a general feeling of weakness may be present if the bleeding is heavy and does not stop easily.

When nosebleeds occur due to Singapore’s dry climate, they can be painful as the nasal cavity becomes irritated. At colder temperatures, nosebleeds are common when the patient is unused to the environment or if there is a sudden change such as entering an air-conditioned shopping centre. 

Rhinitis and sinusitis can cause nosebleeds, especially in chronic conditions. For chronic rhinitis and sinusitis, the nasal cavity is frequently inflamed and this causes the blood vessels in the lining to become ruptured due to repeated swelling.

Nasal polyps can also cause nosebleeds. This is because of how they obstruct the nasal passages as they start to grow in size, leading to friction in the nasal cavity.

In more serious cases, nosebleeds are a sign of cancer. These conditions include paranasal sinus cancer and nasal cavity cancer.

Who is at risk of suffering from Epistaxis in Singapore?

Children and adults in Singapore are equally at risk of suffering from nosebleeds. Living in a dry climate contributes to the likelihood of experiencing nosebleeds. The type of lifestyle the individual engages in can also affect the possibility of having a nosebleed.

Children who like to pick their noses may experience a nosebleed. If caution is not practised, nasal membranes may be damaged or become dry which leads to a nosebleed. If the child is active and prone to injury, the risk for a nosebleed is much higher.

Adults later in life are prone to experiencing nosebleeds. Blood may take longer to clot at the mid-life stage. Those who suffer from bleeding disorders such as haemophilia may also be prone to nosebleeds as the blood doesn’t contain enough blood-clotting proteins to help stop the bleeding.

How is Epistaxis diagnosed?

Nosebleeds or epistaxis are diagnosed during a physical examination. Depending on the severity of the situation, your doctor may perform a complete blood count (CBC) test to check for bleeding disorders. A partial thromboplastin time (PTT) test may also be carried out to check your body’s ability to form blood clots.

A nasal endoscopy will also likely be performed to examine any injuries to the nasal tissues. You will need to let your doctor know about any particular incidents that may have contributed to your nosebleed.

A CT scan might also be carried out to look for the presence of growths such as nasal polyps that may be responsible for the nosebleed. In some cases, an X-ray will be performed of the face and the nose to rule out any other underlying factors.

What are some treatment options for Epistaxis in Singapore?

Nosebleeds or epistaxis can easily be treated in Singapore by determining the cause of bleeding. Typically, the procedure involves nose packing where nasal sponges are placed inside the nose to create pressure at the location of injury. Applying a chemical substance such as silver nitrate to the site of injury (cauterization) can also be done to seal the broken blood vessels and stop bleeding.

Nasal polyps can also be a cause of nosebleeds and are treated by medication or surgery. Your ENT doctor may first prescribe anti-inflammatory medicines such as steroid nasal spray to bring down the swelling. This may help to reduce the occurrence of nosebleeds.

If a deviated nasal septum has been identified as the cause of the nosebleed, your doctor may suggest a surgery to help correct the irregularity.

Allergy & Sinus ENT Specialist Centre
Head & Neck Surgery Singapore

Dr Soma Subramaniam
Consultant ENT Specialist and Surgeon

    * Please note that the requested appointment date and time is subject to availability. The respective clinic will contact you for confirmation.

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