To Your Health

A. Nosebleeds, called epistaxis by doctors, are the most common emergencies seen by ear, nose, and throat specialists. The inside of the nose has a rich supply of blood vessels that tend to bleed, sometimes heavily, when even slightly injured. Only rarely is a nosebleed life-threatening, and this is usually due to another health problem, such as high blood pressure or use of blood-thinning medication working against the blood-clotting process.

Nosebleeds near the front of the nose are called anterior nosebleeds. These are very common, especially in children, and make up 80-90% of all nosebleeds since this area is easily injured. These can usually be stopped within a few minutes. More severe nosebleeds, called posterior bleeds, tend to drain down the back of the throat because they are higher and deeper in the nose. These occur more frequently in elderly people.

Zinc, vitamin C, and bioflavonoids have a reputation for strengthening the walls of blood vessels, but despite a lot of conviction that these nutrients will reduce the risk of nosebleeds, there is no research confirming the effectiveness of these or any nutrient as a remedy for chronic nosebleeds. Supplements of most nutrients are safe enough that many people suffering from frequent nosebleeds take them anyway in the hope that they will help.

Vitamin K is assuredly necessary to make specific blood-clotting factors, but vitamin K should not be supplemented unless tests indicate a need. One nutrient, vitamin E, probably slightly increases the possibility of nosebleeds if used in very large doses.

Most nosebleeds do not have an easily identifiable cause, but you should be aware that certain medicines could lead to nosebleeds. Your health-care provider will tell you that aspirin and nonsteroidal anti-inflammatory drugs, the common pain relievers, predispose to nosebleeds and make treatment difficult. Also, some people with heart problems need to take blood thinners such as warfarin or heparin that will increase the risk of nosebleeds. If you are taking such medications, your doctor may be able to find substitutes. Less well known is the tendency of some antidepressants to cause bleeding disorders by affecting the blood platelets that are involved in blood clotting.

There are rare but serious genetic conditions that show up only later in life as nosebleeds. Hereditary hemorrhagic telangiectasia, also known as Rendu-Osler-Weber disease, is one such disorder that tends to appear after age 50 or so. Nosebleeds are the first and mildest symptom; the effects on brain, liver, lungs, and gastrointestinal tract can be much more serious.

Liquid colostrum, applied by soaking a tissue and inserting it into the nostril that is bleeding, is supposed to be a painless remedy for nosebleeds. If you are very brave, or very desperate, there are some intense folk remedies that promise to stop nosebleeds almost immediately. According to some herbalists, a teaspoon of powdered cayenne pepper in a glass of hot water stops nosebleeds within minutes, but the price is likely to be a severely upset stomach.