Frequent nosebleeds in children refer to recurring nosebleeds in children. This can be caused by non-disease-related reasons such as bad nose habits and dry air, or by diseases such as vitamin deficiency, rhinitis, deviated nasal septum, leukemia, and hereditary hemorrhagic telangiectasia.
symptom
Typical manifestations
Frequent nosebleeds in children are characterized by repeated episodes of bleeding, with blood flowing from one or both nostrils, in varying amounts. Sometimes the blood flows into the pharynx, causing vomiting of blood, or is swallowed, resulting in melena. Children may also experience nasal congestion, itching, purpura, and fever, depending on the cause.
complication
1. Anemia
Frequent nosebleeds in children may lead to excessive blood loss and anemia, which in turn may cause symptoms such as fatigue, dizziness, and headaches.
2. Fear
Frequent nosebleeds may make children feel scared or wonder if they are sick, which is not good for their physical and mental health.
reason
Overview
Clinically, there are many causes of frequent nosebleeds in children, including but not limited to bad nasal habits, dry air, vitamin deficiency, nasal diseases, blood system diseases, etc.
Cause of symptoms
1. Bad nasal habits
Some children have the bad habit of picking their noses. This behavior can easily damage the fragile capillaries in the nasal cavity and may cause frequent nosebleeds.
2. Air drying
In a dry environment, the nasal mucosa becomes dry and brittle and may bleed frequently when irritated.
3. Vitamin deficiency
If children have picky eating habits, it may lead to vitamin deficiencies in the body, especially vitamin C, vitamin K, vitamin P, etc. The lack of these vitamins will increase the fragility and permeability of blood vessels in the nasal cavity, and cause coagulation disorders. The slightest touch may cause nasal blood vessels to rupture and bleed.
4. Nasal diseases
Conditions such as rhinitis, sinusitis, deviated nasal septum, and nasal tumors may lead to inflammation, swelling, damage, or abnormalities in the vascular structure of the nasal mucosa, making the blood vessels under the mucosa more susceptible to damage and rupture, thereby causing bleeding.
5. Blood system diseases
Diseases such as leukemia, aplastic anemia, thrombocytopenic purpura, hereditary hemorrhagic telangiectasia, etc. may lead to abnormal coagulation function, thereby causing frequent nosebleeds in children. These diseases are related to genetic factors.
Common diseases
Vitamin deficiency, rhinitis, sinusitis, deviated nasal septum, nasal tumors, leukemia, aplastic anemia, thrombocytopenic purpura, hereditary hemorrhagic telangiectasia
Seeking medical treatment
Outpatient indications
1. Children have recurrent nosebleeds;
2. Accompanied by symptoms such as nasal congestion and abnormal sense of smell;
3. Accompanied by symptoms such as skin ecchymosis and bleeding gums;
4. Other severe, persistent or progressive symptoms and signs occur.
All of the above require prompt medical consultation.
Treatment department
1. Children should first see an otolaryngologist.
2. If you suspect that it is caused by a blood system disease, you should go to the hematology department for treatment.
3. If malnutrition is suspected, you should go to the nutrition department for treatment.
Medical preparation
1. Make an appointment in advance and bring your ID card, medical insurance card, medical card, etc.
2. A nasal examination may be required, and it is recommended to keep the face and nose clean and hygienic.
3. If you have had medical treatment recently, please bring relevant medical records, examination reports, laboratory test results, etc.
4. If you have taken some medicine to relieve symptoms recently, you can bring the medicine box with you.
5. Family members can be arranged to accompany the patient to seek medical treatment.
6. Patients can prepare a list of questions they want to ask in advance.
What questions might a doctor ask a patient?
1. When did the nosebleed start?
2. How often do nosebleeds occur? How much bleeding is there?
3. What is your daily living environment like? What are your eating habits like?
4. Does your child have the bad habit of picking or blowing his nose?
5. Is there a history of blood disease in the family?
6. Has your child received treatment? How was the treatment? What were the results?
What questions can patients ask their doctor?
1. What causes children to have nosebleeds?
2. Is it serious?
3. What examinations are needed?
4. How is it treated? How long does it take?
5. What should we pay attention to in our daily life to prevent nosebleeds?
6. How often do I need to come to the hospital for a follow-up check?
examine
Scheduled inspection
The doctor will first perform a physical examination on the child, especially the nose, to gain a preliminary understanding of the lesion. He may then recommend a blood test, vitamin determination, four coagulation tests, nasal secretion culture, nasal angiography, anterior rhinoscopy, nasal endoscopy and other examinations to determine the cause of the disease.
Physical examination
1. Nasal examination
The doctor will not only use a nasal speculum to examine the inside of the nasal cavity, look for bleeding points, and assess whether there are any abnormalities in the nasal cavity, such as mucosal damage, foreign objects, tumors, etc.; he will also assess whether there is tenderness or swelling in the sinus area to determine whether there is sinusitis.
2. Others
The doctor will also observe the child’s overall condition, including complexion, color and moisture of the skin and mucous membranes, to make a preliminary assessment of the severity of the disease.
Laboratory tests
1. Blood routine test
This test can understand the levels of white blood cells, red blood cells, platelets, hemoglobin and other indicators, thereby helping to determine whether the child has infection, anemia, bleeding tendency and other problems.
2. Vitamin determination
This test can understand the levels of vitamins such as vitamin C, K, and P in the blood to help determine whether frequent nosebleeds in children are caused by vitamin deficiency, thereby providing a basis for treatment.
3. Four coagulation tests
This test can help diagnose blood disorders by understanding the body’s blood clotting function.
4. Nasal secretion culture
This test can determine whether the patient has a nasal infection and the type of pathogen that causes the infection.
Imaging examinations
Nasal angiography can understand the internal morphology and blood flow of the nasal blood vessels, and help determine whether there are abnormalities in the vascular structure or functional changes.
Other tests
Anterior rhinoscopy and nasal endoscopy are commonly used tools to examine the internal conditions of the nasal cavity, which help identify factors that may cause nosebleeds, such as dry mucosa, deviated nasal septum, and inflammation of the nasal mucosa.
diagnosis
Diagnostic principles
Generally, a definitive diagnosis can be made based on the patient’s medical history, recurrent nosebleeds, and combined with blood routine, vitamin D testing, coagulation tests, nasal secretion culture, nasal angiography, anterior rhinoscopy, and nasal endoscopy. During the diagnosis process, doctors need to differentiate between several common causes of frequent nosebleeds in children, such as rhinitis, deviated septum, and leukemia.
Differential diagnosis
1. Rhinitis
In addition to frequent nosebleeds, this disease can also cause symptoms such as nasal itching, nasal congestion, sneezing, and runny nose. The diagnosis can be confirmed through nasal secretion culture, nasal endoscopy and other examinations.
2. Deviated nasal septum
Nasal septum deviation refers to the deviation or local protrusion of the nasal septum to one side or both sides. In addition to nosebleeds, it can also cause symptoms such as nasal congestion and headache. The diagnosis can be confirmed by anterior rhinoscopy and nasal endoscopy.
3. Leukemia
In addition to nosebleeds, this disease can also cause symptoms such as fever, anemia, and skin purpura. The diagnosis can be confirmed through tests such as coagulation function tests.
treat
Expected treatment
If children have frequent nosebleeds, parents should take them to the doctor in time to find out the cause and then take targeted measures, such as medication, surgery, etc. In addition, parents should pay attention to adjusting the indoor humidity and teach their children to change habits such as nose picking.
Treatment of the cause
1. Rhinitis
Treatment is primarily with medication, commonly used medications include budesonide nasal spray, oxymetazoline hydrochloride nasal drops, and loratadine tablets. If medication is ineffective, severely impacts quality of life, or is complicated by sinusitis, surgical treatment, such as selective nerve resection and inferior turbinate surgery, may be considered.
2. Deviated nasal septum
Children should keep their nasal cavity moist and use nasal irrigation and oily nasal drops such as peppermint oil, while avoiding external irritants. For patients with significant clinical symptoms and unsatisfactory drug responses, surgical treatment may be considered, with common procedures including submucosal septal correction.
3. Leukemia
The treatment plan should be determined according to the type of disease and clinical characteristics, mainly including general treatment (such as blood transfusion, nutrition maintenance, etc.), drug treatment (such as imatinib mesylate, nilotinib, dasatinib, interferon, etc.) and chemotherapy (such as vincristine, prednisone, daunorubicin, etc.). If conditions are suitable, allogeneic hematopoietic stem cell transplantation will also be performed to completely cure the disease.
General treatment
1. Parents can use a humidifier to increase the indoor air humidity appropriately, and ask their children to increase their water intake appropriately to help relieve the dryness of the nasal mucosa.
2. Teach your children not to pick their noses or blow their noses excessively to reduce irritation and damage to the nasal mucosa.
Drug treatment
See treatment of cause for details.
Related drugs
Budesonide nasal spray, oxymetazoline hydrochloride nasal drops, loratadine tablets, peppermint oil, imatinib mesylate, nilotinib, dasatinib, interferon, vincristine, prednisone, daunorubicin
Surgical treatment
See treatment of cause for details.
Treatment cycle
The treatment cycle is affected by factors such as the severity of the disease, treatment plan, treatment timing, age and physical condition, and may vary from person to person.
Estimated treatment costs
There may be significant individual differences in treatment costs, which are related to the selected hospital, treatment plan, medical insurance policy, etc.