I’ve recently had recurring nosebleeds and I hate leaving the house in case they come back. How long will it take for my nose to heal and will I be prone to it in the future?
given name and address.
Nosebleeds fall into two categories – anterior and posterior – depending on which blood vessel the bleeding is coming from.
Anterior nosebleed is the most common and less serious form. It starts at the front of the nose in Little’s area, a point where three arteries meet in the septum, the septum in the middle of your nose.
The best way to stop them is to press directly over your nostrils (not over the bridge of your nose, a common misconception) for 10-15 minutes while leaning slightly forward. (Don’t be tempted to tilt your head back, as this will force blood into your throat.)
Nosebleeds fall into two categories – anterior and posterior – depending on which blood vessel the bleeding is coming from
Bleeding from the back nose starts further back and is more worrisome. Bleeding usually begins in a branch of the sphenopalatine artery and can be rapid and severe. This nosebleed cannot be controlled by pinching your nose and requires specialist attention.
From the description in your longer letter, your nosebleed is frontal – and you ask if it was caused by exercise or leaning over while gardening, but I think that’s unlikely as leaning over isn’t usually a trigger.
A common cause is dry air – such as with central heating – because it can irritate the nasal mucosa. In your opinion, this is what your GP thinks is the most likely.
Other risk factors include taking low-dose aspirin, warfarin, and other drugs used to prevent blood clots.
Some hay fever medications, especially intranasal steroid sprays, can increase the likelihood of nosebleeds, possibly because long-term use of steroids can thin the skin and nasal lining. And recent large studies have confirmed that high blood pressure can also be a factor.
A common cause is dry air – such as with central heating – because it can irritate the nasal mucosa. In your opinion, this is what your GP thinks is the most likely
Recurrent nosebleeds can be distressing and I understand your desire to stay close to home. But it only takes 48-72 hours for the blood vessels behind the front nosebleed to heal, meaning you can safely go about your normal life.
To prevent a recurrence, I recommend the following home remedies so that your nasal mucosa does not dry out. Mix a teaspoon of table salt and a teaspoon of baking soda in half a liter of boiled water and let it cool (you can keep it in the fridge for up to 30 days).
Put a quantity of this solution in the palm of your hand and sniff it in your nostrils once or twice a day, especially if you have the central heating on. I hope this helps.
A recent blood test showed I have a kidney function score of 59 out of the usual 76 (I’m 64). I take lansoprazole to counteract the fact that I take prednisolone for vasculitis. I read that lansoprazole can make kidney problems worse. Is there an alternative?
Crispian Watson, by email
Your concerns about lansoprazole may be misplaced.
Vasculitis, an inflammation of the walls of blood vessels, is a symptom of other diseases, such as rheumatoid arthritis, rather than a disease in itself.
The steroid prednisolone is usually prescribed along with other immunosuppressants to reduce inflammation. Since this often irritates the lining of the stomach, drugs that suppress stomach acid production, such as omeprazole or lansoprazole, can prevent further irritation.
This type of antacid is associated with kidney damage, but it is extremely rare. So, untreated vasculitis is more likely to lead to inflammation of the blood vessels that supply the kidneys, making them less efficient.
A normal kidney function value – which measures filtering capacity – is above 90 ml per minute. The first decline stage, stage two renal failure, is 60 to 89 ml per minute, stage 3A is 45 to 59 ml per minute. Her hair is not a serious deterioration, but it shows that she is not normal. You should discuss this with your advisor. I expect they will suggest continuing your current vasculitis medication to protect your future kidney function. It may sound nerve-wracking, but rest assured that you are getting the right treatment.
Write to Dr. scramble
Write to Dr. Scurr at Good Health, Daily Mail, 2 Derry Street, London W8 5TT or by email at drmartin@dailymail.co. uk – add your contact details. DR Scurr cannot respond to personal correspondence. Answers should be taken in a general context and always consult your GP if you have any health concerns.
In my view: Hidden risk of excesses later in life
The incidence of sexually transmitted diseases has increased recently, with a 20 percent increase in the over 65s.
The increased availability of Viagra along with online dating opens up new opportunities. In itself, this is a good thing, but I still want to be careful.
Condoms aren’t just for birth control—they protect against the rising tide of gonorrhea, chlamydia, herpes, and other genital infections. Syphilis and HIV are also on the rise.
People of retirement age are intent on finding a new and fulfilling adventure, but I urge you not to become blind to the risks of potentially very serious infections.
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Crystal Leahy is an author and health journalist who writes for The Fashion Vibes. With a background in health and wellness, Crystal has a passion for helping people live their best lives through healthy habits and lifestyles.
