Aetiology
Risk factors for epistaxis include: (1)
- a hot, dry indoor climate
- this causes the delicate nasal skin to crack
- occurs more often during changes of seasons before the tissues are still not accustomed to the changes in humidity.
- deviated nasal septum
- this alters airflow pattern and causes the skin on one side of the nasal septum to become dry
- colds and allergies
- upper respiratory tract infections and allergies increase the risk of bleeding due to inflammation
- irritant chemical exposure
- cigarette smoke, sulfuric acid, ammonia, gasoline
- medical causes
- kidney failure, thrombocytopenia, hypertension, hereditary bleeding disorders (e.g. haemophilia)
- alcohol
- drugs
- anticoagulants, nonsteroidal anti-inflammatory drugs (NSAIDs), like aspirin and ibuprofen
- homeopathic medications
- dietary supplements
Causes of epistaxis
- a detailed history and examination readily identifies most causes of nasal bleeding (2)
- these can be considered locally and systemically.
Reference:
- Mulla O, Prowse S, Sanders T, et al; Epistaxis. BMJ. 2012 Feb 23;344
- Tunkel DE, Anne S, Payne SC, et al. Clinical practice guideline: nosebleed (epistaxis). Otolaryngol Head Neck Surg. 2020 Jan;162(suppl 1):S1-38.
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