Dear Doctor,

I get a nosebleed whenever I have a cold. What could be the problem?

George

Dear George,

Nose bleed (epistaxis) with rhinitis is mostly the result of inflammation of the nose. The inner lining of the nose has very delicate capillaries (smallest blood vessels). They can become congested due to the acute inflammation and rupture causing nose bleed. Dryness of the nasal mucosa is one of the most common reasons for nose bleed. Excess dryness causes rupture of blood capillaries. Some people tend to prick their nose, when they feel dry and or itchy inside the nostrils, thus increasing risk of nose bleeds.

One may have a nose bleed due to high blood pressure. The high pressure in blood vessels can cause them to rupture anywhere in the body including the nose. Deficiency of elements causing clotting of blood like platelets, clotting factors, drugs like aspirin, coumadin, liver and kidney diseases, etc. conditions manifest as bleeding anywhere in the body including nose.

Deficiency of vitamin C in the body also increases risk for nose bleeds or bleeding elsewhere.

Recurrent bleeding from nose is a potential source of anaemia due to the blood loss. The best way to prevent it is by preventing dryness inside the nostrils. One can use glycerine, vaseline or any lubricant for this purpose. It should be applied with a clean finger 2 to 3 times every day. Identifying and avoiding allergy causing substances can help in preventing cold due to allergy. A diet including green vegetables, fresh fruits like citrus fruits are also useful. Drinking much water keeps the body well rehydrated and also prevents dryness.

When epistaxis starts, one can pinch the nose very tight for few minutes with thumb and forefinger. This can stop it at the onset.

Dr Rachna Pande  is a specialist in internal medicine at Ruhengeri Hospital