Epistaxis causes
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Editor in Chief: Liudvikas Jagminas, M.D., FACEP [1] Phone: 401-729-2419
Overview
Etiology
The cause of nosebleeds can generally be divided into two categories, local and systemic factors.
Local factors
- Anatomical deformities, such as septal spurs or Osler-Weber-Rendu Syndrome
- Chemical inhalant
- Inflammatory reaction (eg. acute respiratory tract infections, chronic sinusitis, allergic rhinitis and environmental irritants)
- Foreign bodies
- Intranasal tumors (Nasopharyngeal carcinoma in adult, and nasopharyngeal angiofibroma in adolescent males)
- Nasal prong O2 which tends to dry the nasal mucosa
- Nasal sprays, particularly prolonged or improper use of nasal steroids
- Surgery (such as septoplasty and endoscopic sinus surgery)
- Trauma (usually a sharp blow to the face)
- Nose-picking
- Low relative humidity of air breathed occurring especially during winter seasons.
Systemic factors
- Drugs - Aspirin, Fexofenadine/Allegra/Telfast, warfarin, ibuprofen, clopidogrel, isotretinoin, desmopressin and others
- Alcohol (due to vasodilation)
- Allergies
- Blood dyscrasias
- Heart failure (due to an increase in venous pressure)
- Hematological malignancy
- Hypertension
- Infectious diseases
- Malnutrition (especially anemia)
- Narcotics
- Vascular disorders
- Nose-picking (especially in children)
- Muscle tightness as caused by scoliosis (the tightened muscles cause blood vessels to become constricted, resulting in nosebleeds from the same side as the tightened muscles).