Epistaxis: Pathophysiology and Its Management

Epistaxis means bleeding from the nose and is the most common emergency complaint. It is reported in all groups of age. It may generally be spontaneous or be induced by either nose picking or trauma to the inner tissue lining of the nose.  It may also be benign and self-limiting, whereas some can recur time. Epistaxis is a minor problem and can be treated easily, but sometimes it can lead to a life-threatening hemorrhage. Environmental factors can affect the frequency of epistaxis. That is, it increases in the winters as compared to other seasons. It is because of decreased humidity during the winters, which ultimately leads to reduced humidification of the nose. Based on origin, epistaxis can be of two types- Anterior epistaxis and Posterior epistaxis. Anterior epistaxis originates from the Kiesselbach plexus in the frontal part of the nose, whereas the posterior epistaxis originates from the Woodruff plexus lying in the posterior or superior nasal cavity. Various local and systemic factors can cause it. Local factors contributing to nose bleeding are either localized trauma (nose picking) or facial trauma, anatomical abnormalities, inflammatory causes, etc. Systemic conditions that increase epistaxis risk are high blood pressure, cardiovascular diseases, and vascular and bleeding disorders. Epistaxis can often be managed at home or by a primary care general physician. But in cases where it is recurrent, or the bleeding is non-stop, the patient should immediately go to the hospital and take proper treatment.