Nosebleed (medically known as epistaxis) is a common ENT symptom, and although it can be scary to most people, it is usually not due to a serious health problem. Majority of nosebleeds are due to a burst vessel somewhere in the nasal cavity. I will answer your question in two parts:
What causes nosebleeds?
The causes of nosebleed can divided into local and systemic causes as follows:
a) Local causes:
1) Enlarged blood vessels (telangiectasia) in the nose. This is the cause of over 90% of nosebleed encountered in my practice.
2. Rhinitis (Sensitive nose)
3. Sinusitis (Infection of the sinuses)
4. Trauma (e.g. frequent nose picking, sporting injuries and road traffic accidents)
5. Tumour
Systemic causes:
1. Uncontrolled blood pressure
2. Medications that thins the blood (E.g. aspirin, warfarin, plavix etc)
3. Disorders that cause problem with blood clotting (E.g liver disease, platelet dysfunction, low platelet counts, low blood clotting factors etc)
If I have a nosebleed, does that mean I have cancer?
Many people are worried of cancer as a cause of nosebleeds. Vascular tumours (tumours arising from blood vessels) or large cancer of the nose can cause significant nosebleeds. However, these are fortunately not common. Most cancer of the nose (medically known as nasopharyngeal carcinomas) presents more often with blood-stained mucous or blood in the saliva/phlegm, blocked ears and neck lumps.
If you have a family history of nose cancer, you may want to consider having an assessment by an ENT Specialist. The Ministry of Health Singapore Cancer Screening Guidelines recommends screening for nose cancer for patients with two or more relatives or family members with nose cancer. If your nosebleed is due to enlarged blood vessels in the nose, these can be easily sealed off in the clinic (using silver nitrate sticks) under local anaesthesia) by your ENT Specialist.
Hope this helps and all the best.
