I have recently started to have nosebleeds on a regular basis. They can last for quite a long time but do stop eventually if I press on my nose.I don't have any other illness that I'm aware of and I feel pretty well. Is this something I should worry about?
DR NINA: The medical term for nose bleeds is epistaxis. It is a common problem thought to occur in up to 60pc of the population at some stage. It occurs mainly in children under the age of 10 in those over the age of 50.
Nose bleeds can appear quite dramatic but in most cases resolve with simple measures and most people do not seek medical attention for a simple bleed.
The most common cause of nosebleeds is trauma to the inside of the front part of the nose most commonly due to nose-picking. Other causes of trauma to the nose include insertion of foreign bodies into the nasal cavity and frequent nose-blowing. Bleeding may occur more commonly if you have a sinus or respiratory infection for this reason.
The use of blood-thinning medication such as aspirin or warfarin or the use of nasal sprays which may dry out the nose can also increase the chance of bleeding. Cocaine use damages the lining of the nose and increases the chance of nose bleeds.
Those who have clotting problems also have an increased risk of nose bleeds. Platelets are a cell in the blood that aids clotting deficiencies. These can occur due to disease or certain drugs and excess alcohol. If platelets drop very low bleeding may occur.
More rarely disease of the nose and nasal passage such as auto immune conditions or tumours or abnormalities of the nose and pharynx may cause bleeding.
People often worry about high blood pressure when nose bleeds occur but this is not a common way for blood pressure to show itself.
The area just inside the nose, referred to as Little's area, has a high concentration of blood vessels near the surface and most nose bleeds originate in this area.
These bleeds usually come mainly from one nostril. If blood is coming from both nostrils or going down the back of the throat the source of the bleed is more likely to be further towards the back of the nose.
If your nose starts bleeding you should lean forwards and put firm pressure across the lower part of your nose (not the bony bridge) and hold it firmly for five to 20 minutes.
Applying something cold like an ice pack or frozen veg pack may help constrict blood vessels and shorten the bleed. Breath through your mouth and spit any blood into a bowl. Once the bleed has stopped avoid picking at the nose or blowing it for a further 20 minutes.
If nose bleeds are infrequent and settle with the above measures medical review is not necessary. If nose bleeds are occurring frequently, are prolonged or if you have noticed any other bleeding or bruising it is worth seeing your doctor.
A doctor review will involve a general exam of the nasal cavity and possibly some basic blood tests. If Little's area is inflamed applying a prescription cream to this area may allow healing.
In more severe or recurrent cases the nose may need to be cauterised or packed and further investigation and review with and ear nose and throat doctor may be required.
My doctor told me this was ok because the breakdown was good. I thought over 5 was bad and now I am very confused. Can you help me understand cholesterol please?
DR NINA: Cholesterol is a wax-like substance that is found in every cell in the body. It makes up part of the wall or membranes of cells and plays a role in the production of hormones and bile acid which aids the digestion of fats.
Cholesterol cannot dissolve in blood and so is carried around by a number of different types of proteins called lipoproteins. Low density lipoprotein (LDL) carries cholesterol from the liver to the rest of the body. If there is too much of this protein circulating cholesterol may end up being deposited in the walls of arteries leading to the formation of plaques. LDL is often referred to as bad cholesterol.
High density lipoprotein carries cholesterol from the body back to the liver where it can be broken down and disposed of. HDL is often referred to as good cholesterol.
Triglycerides are the chemical form in which fat occurs in foods and in our bodies. If we ingest too much fat these levels can build up in our bodies and increase in the blood. Triglycerides are another form of bad fat.
Other proteins involved in the management of cholesterol in our bodies include apo(a) lipoprotein which is under genetic control. Those with a genetic risk of cardiovascular disease may have higher levels of this protein.
Things that increase levels of bad cholesterol include obesity, inactivity, a diet high in saturated fats, and genetics. Smoking and excess alcohol can also negatively impact on cholesterol levels. Exercise can increase the levels of good cholesterol.
Your total cholesterol level of 5.4 was a sum of the good and bad components. It is helpful to know the breakdown of the different types. It sounds like your HDL was high which is protective to the heart. Aim for high levels of H (DL) and low levels of L (DL).
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