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Why does my son’s nose bleed so often?

Wednesday, 07 October 2009
Answered by: Dr (Prof) D Balakrishnan
Consultant Paediatric ENT Surgeon, Kanchi Kamakoti Child Trust Hospital, Chennai
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Q. My 3 years old son is having a problem of nose bleeding. Two years back he fell down and at that time his nose bled. Since then his nose begins to bleed anytime but only from the right nostril. The doctor said that it is because of iron deficiency but another doctor said it might be due to the heat. Sometimes at night or when he cries his nose starts bleeding for a few seconds. What is the exact reason of this problem? His haemoglobin is 11.8. Please advise.

A.  The function of the nose is to air condition the inspired air. From the inspired air, first the coarse dust is removed. Then, the temperature of the air is adjusted to that of the body. Then, any small dust particles that might be present in the inspired air are trapped in the mucus blanket. This is a very complex job. In fact, the nose is the best air conditioning machine in the world. To do this job efficiently, it requires a lot of blood flowing into it. Hence, nasal bleed is quite common.

Any small injury might cause bleeding from the nose. The commonest cause in an otherwise healthy child is injury while playing. The next common cause is cold and consequent crusting of the nose. Because of the itching and the irritation due to the crustation, the child may pick the nose and cause bleeding. Dry ambient air might also cause drying up of the nasal mucus and cause crusting. In a few persons, the blood may not clot properly. Hence, after even a very small injury, the bleeding may continue unabated. However, if the bleeding stops after a few seconds, as you have described, the chances of such a disorder are remote. You may request your doctor to rule out any bleeding disorder. Some simple tests are available to do this.

Hence, please see whether your son's nasal bleed is associated with cold. If it is so, kindly get the cold treated. Avoiding any injury will be possible with some gentle persuasion of the child. Please ensure that the child drinks adequate quantities of water and other beverages. Always keep the nails trimmed properly. Learn the first aid for nasal bleed. Basically, the first aid techniques comprise of methods of pinching the nose and application of cold water or ice packs to the external nose. Again, your doctor can guide you.

A.  The function of the nose is to air condition the inspired air. From the inspired air, first the coarse dust is removed. Then, the temperature of the air is adjusted to that of the body. Then, any small dust particles that might be present in the inspired air are trapped in the mucus blanket. This is a very complex job. In fact, the nose is the best air conditioning machine in the world. To do this job efficiently, it requires a lot of blood flowing into it. Hence, nasal bleed is quite common.

Any small injury might cause bleeding from the nose. The commonest cause in an otherwise healthy child is injury while playing. The next common cause is cold and consequent crusting of the nose. Because of the itching and the irritation due to the crustation, the child may pick the nose and cause bleeding. Dry ambient air might also cause drying up of the nasal mucus and cause crusting. In a few persons, the blood may not clot properly. Hence, after even a very small injury, the bleeding may continue unabated. However, if the bleeding stops after a few seconds, as you have described, the chances of such a disorder are remote. You may request your doctor to rule out any bleeding disorder. Some simple tests are available to do this.

Hence, please see whether your son's nasal bleed is associated with cold. If it is so, kindly get the cold treated. Avoiding any injury will be possible with some gentle persuasion of the child. Please ensure that the child drinks adequate quantities of water and other beverages. Always keep the nails trimmed properly. Learn the first aid for nasal bleed. Basically, the first aid techniques comprise of methods of pinching the nose and application of cold water or ice packs to the external nose. Again, your doctor can guide you.

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