Why do people nosebleed

Nosebleed | NHS inform

About nosebleeds

Nosebleeds can be frightening, but they aren't usually a sign of anything serious and can often be treated at home.

The medical name for a nosebleed is epistaxis.

During a nosebleed, blood flows from one or both nostrils. It can be heavy or light and last from a few seconds to 15 minutes or more.

What to do

To stop a nosebleed:

• sit down and firmly pinch the soft part of your nose, just above your nostrils, for at least 10 to 15 minutes
• lean forward and breathe through your mouth – this will drain blood into your nose instead of down the back of your throat
• place an ice pack or bag of frozen vegetables covered by a towel on the bridge of your nose
• stay upright, rather than lying down, as this reduces the blood pressure in the blood vessels of your nose and will discourage further bleeding

If the bleeding eventually stops, you won't usually need to seek medical advice. However, in some cases you may need further treatment from your GP or in hospital.

Read more about treating nosebleeds

When to seek medical advice

Non-urgent advice: Contact your GP practice if:

• you're taking a blood-thinning medicine (anticoagulant) such as warfarin or have a clotting disorder such as haemophilia and the bleeding doesn't stop
• you have symptoms of anaemia such as heart palpitations, shortness of breath and a pale complexion
• a child under 2 years of age has a nosebleed
• you have nosebleeds that come and go regularly

If your GP practice is closed, phone 111.

Immediate action required: Go to your nearest accident and emergency (A&E) or phone 999 if:

• the bleeding continues for longer than 20 minutes
• the bleeding is heavy and you've lost a lot of blood
• you're having difficulty breathing
• you swallow a large amount of blood that makes you vomit
• the nosebleed developed after a serious injury, such as a car crash

What causes nosebleeds?

The inside of your nose is full of tiny, delicate blood vessels that can become damaged and bleed relatively easily.

Common causes of nosebleeds include:

• picking your nose
• blowing your nose very hard
• a minor injury to your nose
• changes in humidity or temperature causing the inside of the nose to become dry and cracked

Occasionally, bleeding can come from the blood vessels deeper within the nose. This can be caused by a blow to the head, recent nasal surgery and hardened arteries (atherosclerosis).

Read more about the causes of nosebleeds

Who gets nosebleeds?

Nosebleeds are fairly common and most people will experience them every now and again. Anyone can get a nosebleed, but they most often affect:

• children between 2 and 10 years of age
• elderly people
• pregnant women
• people who take blood thinning medication such as aspirin or anticoagulants, such as warfarin
• people with blood clotting disorders, such as haemophilia

Bleeding may also be heavier or last longer if you take anticoagulants, have a blood clotting disorder, or have high blood pressure (hypertension).

Are nosebleeds serious?

Nosebleeds aren't usually serious. However, frequent or heavy nosebleeds may indicate more serious health problems, such as high blood pressure or a blood clotting disorder, and should be checked.

Excessive bleeding over a prolonged period of time can also lead to further problems such as anaemia.

If your GP suspects a more serious problem is causing your nosebleeds, they may refer you to an ear, nose and throat (ENT) specialist for further tests.

Preventing nosebleeds

There are things you can do to prevent nosebleeds.

Do

• avoid picking your nose and keep your fingernails short
• blow your nose as little as possible and only very gently
• keep your home humidified
• wear a head guard during activities in which your nose or head could get injured
• always follow the instructions that come with nasal decongestants – overusing these can cause nosebleeds

Talk to your GP if you experience nosebleeds frequently and aren't able to prevent them. They may refer you to an ENT specialist for an assessment.

Causes of nosebleeds

Nosebleeds can be caused by a number of different things. It's not always possible to identify the exact reason why one occurs.

Nosebleeds can start just inside your nostrils (anterior) or at the back of your nose (posterior). These different types of nosebleeds tend to have different causes.

Anterior nosebleeds

The vast majority of nosebleeds are anterior nosebleeds, which means the bleeding comes from the wall between the two nose channels (the lower septum), just inside your nose. This part of the nose, known as Little's area, contains many delicate blood vessels that can be easily damaged.

The cause of anterior nosebleeds is sometimes unknown, but they can be caused by a number of things, including:

• picking your nose, particularly if you scratch the inside of your nose with a sharp fingernail
• blowing your nose very hard
• a minor injury to your nose
• a blocked or stuffy nose often caused by an infection such as a cold or flu
• sinusitis – an infection of the small, air-filled cavities inside your cheekbones and forehead
• dry air or an increase in temperature drying out the inside of your nose
• hay fever or other allergies
• high altitude
• excessive use of nasal decongestants
• a crooked nasal septum that's either present from birth (congenital) or the result of an injury (a deviated septum)

Anterior nosebleeds are more common in children and are not usually a sign of anything serious. They can often be treated easily at home.

Read more about treating nosebleeds

Posterior nosebleeds

A small number of nosebleeds are posterior nosebleeds, which means the bleeding originates from branches of arteries that supply blood to the space inside your nose between the roof of your mouth and your brain (nasal cavity).

These nosebleeds are more common in adults than children. They can be more serious than anterior nosebleeds and bleed more heavily. Medical attention may be required.

Causes of posterior nosebleeds include:

• a blow to your head, or a fall
• a broken nose
• recent nasal surgery
• hardened arteries (atherosclerosis)
• medicines that cause you to bleed more easily, including aspirin and anticoagulants such as warfarin and heparin
• a tumour in the nasal cavity
• a blood clotting abnormality – such as haemophilia or von Willebrand disease
• hereditary haemorrhagic telangiectasia (HHT) – an inherited genetic condition that affects the blood vessels
• leukaemia (although this is rare and you're likely to have other symptoms as well)

High blood pressure (hypertension) is also more common in people with nosebleeds and may make it harder to stop the bleeding, but it's not clear whether this directly causes nosebleeds.

Treating nosebleeds

Most nosebleeds can be stopped without the need for medical attention, but occasionally further treatment may be required.

What to do

To stop a nosebleed:

• sit down and firmly pinch the soft part of your nose, just above your nostrils, for at least 10-15 minutes
• lean forward and breathe through your mouth – this will drain blood into your nose instead of down the back of your throat
• place an ice pack or bag of frozen vegetables covered by a towel on the bridge of your nose
• stay upright, rather than lying down as this reduces the blood pressure in the blood vessels of your nose and will discourage further bleeding

If the bleeding eventually stops, you won't usually need to seek medical advice. However, you should still follow our recovery advice.

Non-urgent advice: Contact your GP practice if:

• you're taking a blood-thinning medicine (anticoagulant) such as warfarin or have a clotting disorder such as haemophilia and the bleeding doesn't stop
• you have symptoms of anaemia such as heart palpitations, shortness of breath and a pale complexion
• a child under 2 years of age has a nosebleed
• you have nosebleeds that come and go regularly

If your GP practice is closed, phone 111.

Immediate action required: Go to your nearest accident and emergency (A&E) or phone 999 if:

• the bleeding continues for longer than 20 minutes
• the bleeding is heavy and you've lost a lot of blood
• you're having difficulty breathing
• you swallow a large amount of blood that makes you vomit
• the nosebleed developed after a serious injury, such as a car crash

Find your nearest A&E department

Medical treatment

If you see your GP or go to hospital with a nosebleed, you will be assessed to determine how serious your condition is and what's likely to have caused it. This may involve looking inside your nose, measuring your pulse and blood pressure, carrying out blood tests and asking about any other symptoms you have.

These are the main treatments that your GP or hospital doctor may use to stop your nose bleeding.

Antibiotic ointment

Your doctor may prescribe an antibiotic ointment. This should be applied by squeezing a pea-sized amount onto the front of the nasal septum (wall between the nostrils).

This can reduce the inflammation and crusting in the nose and reduce the severity and frequency of nosebleeds.

Antibiotic ointment is particularly effective in children.

Cautery

If your doctor is able to identify exactly where the bleeding is coming from, they may carry out a minor procedure to seal the bleeding blood vessel by cauterising (burning) it.

This is normally done using a stick of a chemical called silver nitrate. A local anaesthetic will be sprayed into your nose to numb it and the silver nitrate stick will be held against the bleeding point for up to 10 seconds.

Nasal packing

If cautery is ineffective or your doctor is unable to identify a specific bleeding point, they may recommend packing your nose with gauze or special nasal sponges to stop the flow of blood by applying pressure to the source of the bleeding.

Packing will usually be carried out after local anaesthetic has been sprayed into your nose. The gauze or sponges often need to be left in place for 24-48 hours before being removed by a health professional. You'll usually need to be admitted to hospital to be monitored during this time.

Further treatment

If the treatments above don't help, you may be referred to a hospital specialist such as an ear, nose and throat (ENT) doctor for further treatment.

Additional treatments that may be used in hospital include:

• electrocautery – an electric current running through a wire is used to cauterise the blood vessel where the bleeding is coming from
• blood transfusions – a procedure to replace the blood you've lost
• tranexamic acid – medication that can reduce bleeding by helping your blood to clot
• packing under anaesthetic – your nose is carefully packed with gauze while you are unconscious from general anaesthetic
• ligation – an operation using small instruments to tie off bleeding blood vessels in the back of your nose

Recovery

Once your nose has stopped bleeding, you should follow the advice below to reduce the risk of your nose bleeding again and to stop you picking up an infection:

• avoid blowing or picking your nose, heavy lifting, strenuous exercise, lying flat, and drinking alcohol or hot drinks for 24 hours
• don't remove any crusts that form inside your nose – these may be unpleasant, but they're a useful part of the healing process
• if you need to sneeze, try to sneeze with your mouth open to reduce the pressure in your nose
• avoid people with coughs and colds

If you see a GP or a hospital doctor about your nosebleed, they may give you a prescription for an antiseptic nasal cream once the bleeding stops. This should be applied to the inside of your nostrils several times a day for up to two weeks to help prevent further bleeding.

If your nose does start to bleed again, follow the first aid advice above and seek medical advice if the bleeding doesn't stop.

Iron deficiency anaemia - Illnesses & conditions

See all parts of this guide Hide guide parts

1. 1. About iron deficiency anaemia
2. 2. Causes of iron deficiency anaemia
3. 3. Diagnosing iron deficiency anaemia
4. 4. Treating iron deficiency anaemia
5. 5. Complications of iron deficiency anaemia

About iron deficiency anaemia

Iron deficiency anaemia is a condition where a lack of iron in the body leads to a reduction in the number of red blood cells.

Iron is used to produce red blood cells, which help store and carry oxygen in the blood. If you have fewer red blood cells than is normal, your organs and tissues won't get as much oxygen as they usually would.

There are several different types of anaemia, and each one has a different cause. Iron deficiency anaemia is the most common type.

Other types of anaemia can be caused by a lack of vitamin B12 or folate in the body – read more about vitamin B12 and folate deficiency anaemia.

Symptoms of iron deficiency anaemia

Many people with iron deficiency anaemia only have a few symptoms. The severity of the symptoms largely depends on how quickly anaemia develops.

You may notice symptoms immediately, or they may develop gradually if your anaemia is caused by a long-term problem, such as a stomach ulcer.

The most common symptoms include:

• tiredness and lack of energy (lethargy)
• shortness of breath
• noticeable heartbeats (heart palpitations)
• a pale complexion

Less common symptoms include:

• headache 
• hearing sounds that come from inside the body, rather than from an outside source (tinnitus)
• an altered sense of taste
• feeling itchy
• a sore or abnormally smooth tongue
• hair loss
• a desire to eat non-food items, such as ice, paper or clay (pica)
• difficulty swallowing (dysphagia)
• painful open sores (ulcers) on the corners of your mouth
• spoon-shaped nails

When to see your GP

See your GP if you experience symptoms of iron deficiency anaemia. They should be able to diagnose the condition using a simple blood test.

Read more about diagnosing iron deficiency anaemia

What causes iron deficiency anaemia?

There are many things that can lead to a lack of iron in the body. In men and post-menopausal women, the most common cause is bleeding in the stomach and intestines.

This can be caused by a stomach ulcer, stomach cancer, bowel cancer, or by taking non-steroidal anti-inflammatory drugs (NSAIDs).

In women of reproductive age, heavy periods and pregnancy are the most common causes of iron deficiency anaemia as your body needs extra iron for your baby during pregnancy.

Unless you're pregnant, it's rare for iron deficiency anaemia to be caused just by a lack of iron in your diet. However, if you do lack dietary iron, it may mean you're more likely to develop anaemia than if you have one of the problems mentioned above.

Read more about the causes of iron deficiency anaemia

How iron deficiency anaemia is treated

Treatment for iron deficiency anaemia involves taking iron supplements to boost the low levels of iron in your body. This is usually effective, and the condition rarely causes long-term problems.

You'll need to be monitored every few months to check the treatment is working and your iron levels have returned to normal.

The underlying cause will need to be treated so you don't get anaemia again. Increasing the amount of iron in your diet may also be recommended.

Good sources of iron include:

• dark-green leafy vegetables, such as watercress and curly kale
• iron-fortified cereals or bread
• brown rice 
• pulses and beans
• nuts and seeds
• meat, fish and tofu
• eggs
• dried fruit, such as dried apricots, prunes and raisins

Read more about treating iron deficiency anaemia

Further problems

If iron deficiency anaemia is left untreated, it can make you more susceptible to illness and infection, as a lack of iron affects the body's natural defence system (the immune system).

Severe iron deficiency anaemia may increase your risk of developing complications that affect the heart or lungs, such as an abnormally fast heartbeat (tachycardia) or heart failure, where your heart is unable to pump enough blood around your body at the right pressure.

Pregnant women with severe or untreated anaemia also have a higher risk of complications before and after birth.

Read more about the complications of iron deficiency anaemia

Causes of iron deficiency anaemia

Iron deficiency anaemia occurs when the body doesn't have enough iron, leading to the decreased production of red blood cells. Red blood cells carry oxygen around the body.

A lack of iron can be caused by several factors. Some of the most common causes of iron deficiency anaemia are outlined below.

Monthly periods

In women of reproductive age, periods are the most common cause of iron deficiency anaemia.

Usually, only women with heavy periods develop iron deficiency anaemia. If you have heavy bleeding over several consecutive menstrual cycles, it's known as menorrhagia.

Pregnancy

It's also very common for women to develop iron deficiency during pregnancy.

This is because your body needs extra iron to ensure your baby has a sufficient blood supply and receives necessary oxygen and nutrients.  

Some pregnant women require an iron supplement, while others may need to increase the amount of iron in their diet.

Read more about vitamins and minerals in pregnancy

Gastrointestinal blood loss

The gastrointestinal tract is the part of the body responsible for digesting food. It contains the stomach and intestines.

Bleeding in the gastrointestinal tract is the most common cause of iron deficiency anaemia in men, as well as women who've experienced the menopause (when monthly periods stop).

Most people with gastrointestinal bleeding don't notice any obvious blood in their stools and don't experience any changes in their bowel habits.

Some causes of gastrointestinal bleeding are described below.

Non-steroidal anti-inflammatory drugs

Non-steroidal anti-inflammatory drugs (NSAIDs) can cause bleeding in the stomach. Ibuprofen and aspirin are two commonly prescribed NSAIDs.

If your GP thinks your medication is causing gastrointestinal bleeding, they can prescribe a less harmful medicine. However, don't stop taking a medicine you've been prescribed unless your GP advises you to.

Stomach ulcers

The acid in your stomach, which helps your body digest food, can sometimes eat into your stomach lining. When this happens, the acid forms an open sore (an ulcer). This is also known as a stomach ulcer or a peptic ulcer.

Stomach ulcers can cause the stomach lining to bleed, which can lead to anaemia. In some cases, the bleeding can cause you to vomit blood or pass blood in your stools. However, if the ulcer bleeds slowly, you may not have any symptoms.

Gastrointestinal cancer

In a few cases, gastrointestinal bleeding can be caused by cancer, usually stomach cancer or bowel cancer.

When trying to establish the cause of anaemia, your GP will check for possible signs of cancer.

If your GP suspects cancer, you'll be referred to a gastroenterologist (a specialist in treating digestive conditions) for a more thorough examination. This means that if cancer is found, it can be treated as quickly as possible.

If you're 60 years old or over and have iron deficiency anaemia, your GP should refer you to a specialist to rule out bowel cancer. Your  appointment with the specialist should be within two weeks of your GP referring you.

Angiodysplasia

Gastrointestinal bleeding can also be caused by a condition called angiodysplasia. This is the result of abnormal, fragile superficial blood vessels in the gastrointestinal tract, which can cause bleeding.

Chronic kidney disease

People with chronic kidney disease (CKD) often develop iron deficiency anaemia.

Most people with CKD who have iron deficiency anaemia will be given iron supplement injections, although daily tablets may be tried first.

You can read more about treating anaemia in people with CKD on the National Institute for Health and Care Excellence (NICE) website.

Other causes

Other conditions or actions that cause blood loss and may lead to iron deficiency anaemia include:

• inflammatory bowel disease – a condition that causes redness and swelling (inflammation) in the digestive system, such as Crohn's disease and ulcerative colitis 
• oesophagitis – inflammation of the gullet (oesophagus) caused by stomach acid leaking through it
• schistosomiasis – an infection caused by parasites, mainly found in sub-Saharan Africa
• blood donation – donating a large amount of blood may lead to anaemia
• trauma – a serious accident, such as a car crash, may cause you to lose a large amount of blood 
• nosebleeds – having regular nosebleeds may lead to anaemia, although this is rare
• haematuria (blood in your urine) – but this rarely causes anaemia and may be a symptom of another condition

Malabsorption

Malabsorption is when your body can't absorb iron from food, and is another possible cause of iron deficiency anaemia.

This may happen if you have coeliac disease, a common digestive condition where a person has an adverse reaction to gluten, or surgery to remove all or part of your stomach (gastrectomy).

Lack of iron in your diet

Unless you're pregnant, it's rare for iron deficiency anaemia to be caused solely by a lack of iron in your diet.

However, a lack of dietary iron can increase your risk of developing anaemia if you also have any of the conditions mentioned above.

Some studies suggest vegetarians or vegans are more at risk of iron deficiency anaemia because of the lack of meat in their diet.

If you are vegetarian or vegan, it is possible to gain enough iron by eating other types of food, such as:

• beans
• nuts
• dried fruit, such as dried apricots
• wholegrains, such as brown rice
• fortified breakfast cereals
• soybean flour
• most dark-green leafy vegetables, such as watercress and curly kale

If you're pregnant, you may need to increase the amount of iron-rich food you consume during pregnancy to help prevent iron deficiency anaemia.

Read more about vegetarian and vegan diets

Diagnosing iron deficiency anaemia

See your GP if you experience symptoms of iron deficiency anaemia, such as tiredness, shortness of breath and heart palpitations.

A simple blood test can usually confirm the diagnosis.

Your GP may also carry out a physical examination and ask you a number of questions to help determine the cause of your anaemia.

Blood test

To diagnose iron deficiency anaemia, a blood sample is taken from a vein in your arm and a full blood count is made. This means all the different types of blood cells in the sample will be measured.

If you have anaemia:

• your levels of haemoglobin – a substance that transports oxygen – will be lower than normal
• you'll have fewer red blood cells, which contain haemoglobin, than normal
• your red blood cells may be smaller and paler than usual

Your GP may also test for a substance called ferritin, a protein that stores iron. If your ferritin levels are low, it means there isn't much iron stored in your body and you may have iron deficiency anaemia.

Read more about blood tests 

Vitamin B12 and folate deficiency

If your GP thinks your anaemia may be the result of a vitamin B12 and folate deficiency, the levels of these substances may be tested. Folate works with vitamin B12 to help your body produce red blood cells.

Vitamin B12 and folate deficiency anaemia is more common in people who are over the age of 75.

Finding the cause

To determine the underlying cause of your anaemia, your GP may ask questions about your lifestyle and medical history. For example, they may ask you about:

• your diet – to see what you typically eat and whether this includes any iron-rich foods
• any medicines you take – to see if you've been regularly taking a type of medicine that can cause bleeding from the stomach and intestines (gastrointestinal bleeding), such as ibuprofen or aspirin
• your menstrual pattern – if you're a woman, your GP may ask if you've been experiencing particularly heavy periods
• your family history – you'll be asked if your immediate family has anaemia or a history of gastrointestinal bleeding or blood disorders

Iron deficiency anaemia is common during pregnancy. If you're pregnant, your GP will usually only look for an alternative cause if a blood test has identified a particularly low haemoglobin level, or if your symptoms or medical history suggest your anaemia may be caused by something else.

Physical examination

A physical examination will usually only be needed if the cause of your iron anaemia deficiency hasn't been identified by examining your medical history and asking you about your symptoms.

In such cases, your GP may:

• examine your stomach (abdomen) to check for any physical signs of gastrointestinal bleeding
• look for signs of heart failure, such as swollen ankles – heart failure can have some similar symptoms to iron deficiency anaemia

Two other possible types of physical examination you may have are explained below.

Rectal examination

A rectal examination is usually only needed if you're bleeding from your bottom. It's a common procedure that can help your GP find out if there's something in your gastrointestinal tract that's causing bleeding.

Your GP will insert a lubricated gloved finger into your bottom to feel for any abnormalities.

A rectal examination isn't something to be embarrassed about, as it's a procedure your GP will be used to doing. It shouldn't cause significant pain, but it may cause some slight discomfort – this will only last for a minute.

Pelvic examination

Women may have a pelvic examination if their GP thinks heavy menstrual bleeding (menorrhagia) may be the cause of their anaemia.

During a pelvic examination, your GP will examine your vulva and labia (external sex organs) for signs of bleeding or infection.

They may also examine you internally. This will involve your GP inserting lubricated gloved fingers into your vagina to feel whether your womb (uterus) is tender or enlarged.

A pelvic examination won't be carried out without your consent (permission), and you can choose to have someone with you.

Referral to a specialist

In some cases, your GP may refer you to a gastroenterologist, a specialist in treating digestive conditions. They'll carry out a more thorough examination.

For example, you may be referred to a gastroenterologist if your GP can't identify a cause and you have a particularly low haemoglobin level, or if your GP thinks there's a possibility your symptoms could be caused by stomach cancer or bowel cancer, although this is unlikely.

If you're a woman with heavy periods, you may be referred to a gynaecologist if you don't respond to treatment with iron supplements.

Treating iron deficiency anaemia

Treatment for iron deficiency anaemia usually involves taking iron supplements and changing your diet to increase your iron levels, as well as treating the underlying cause.

Iron supplements

Your GP will prescribe an iron supplement to restore the iron missing from your body. The most commonly prescribed supplement is ferrous sulphate, which is taken as a tablet, usually twice a day.

Some people can experience side effects when taking iron supplements, including:

• abdominal (tummy) pain
• constipation or diarrhoea
• heartburn
• feeling sick
• black stools (faeces)

These side effects should settle down over time. However, your GP may recommend taking the tablets with food or shortly after eating if you have troublesome side effects.

Your GP may also advise you to only take one or two tablets a day, instead of three, if you're finding side effects difficult to cope with.

If you can't take ferrous sulphate because you get severe side effects, you may be prescribed a different iron supplement called ferrous gluconate.

This supplement should cause fewer side effects because it contains a less concentrated dose of iron. However, it may take longer for the iron levels in your body to be restored.

In a few cases – for example, if you have chronic kidney disease (CKD) – iron injections may be recommended instead of tablets.

As with all medications, it's important to store iron supplements out of the reach of children. An overdose of iron supplements in a young child can be fatal.

Dietary advice

If a lack of iron in your diet is thought to be contributing to your iron deficiency anaemia, your GP will tell you how to up your intake.

Iron-rich foods include:

• dark-green leafy vegetables, such as watercress and curly kale
• iron-fortified cereals or bread
• brown rice 
• pulses and beans 
• nuts and seeds
• white and red meat 
• fish 
• tofu
• eggs 
• dried fruit, such as dried apricots, prunes and raisins

Your diet should include foods from all the major food groups to ensure it's healthy and balanced. In particular, food and drink containing vitamin C are important as vitamin C helps your body absorb iron.

However, consuming large amounts of some foods and drinks, as well as certain medicines, may make it harder for your body to absorb iron. These include:

• tea and coffee
• calcium – found in dairy products, such as milk 
• antacids and proton pump inhibitors (PPIs) – medications used to relieve indigestion
• wholegrain cereals – although wholegrains are a good source of iron themselves, they contain phytic acid, which can stop your body absorbing iron from other foods and pills

You may be referred to a nutrition specialist called a dietitian if you're finding it difficult to include iron in your diet. They'll be able to give you detailed, personalised advice about how you can improve your diet.

Treating the underlying cause

Your GP will also need to ensure the underlying cause of your anaemia is treated so it doesn't happen again.

For example, if non-steroidal anti-inflammatory drugs (NSAIDs) are causing bleeding in your stomach, your GP may prescribe a different medicine to help minimise the risk of stomach bleeding.

Heavy periods can be treated with medication or – in particularly severe cases – surgery.

Monitoring

Your GP will ask you to return two to four weeks after you've started taking iron supplements to check how well you've responded to the treatment. You'll have a blood test to check your haemoglobin levels.

If your blood test results show an improvement, you'll be asked to continue taking iron supplements and return in two to four months for another blood test.

Once your haemoglobin levels and red blood cells are normal, your GP will usually recommend continuing to take iron supplements for three months to help build up the iron levels in your body.

After this, you should be able to stop taking the supplements, depending on the cause of your iron deficiency anaemia. Your condition will be monitored every three months over the course of a year, and again a year later.

Continuing treatment

Sometimes after a person's iron levels have been replenished, they start to fall again.

This could happen if you don't get enough iron in your diet, you're pregnant, or you have consistently heavy periods.

In such cases, you may be prescribed an ongoing iron supplement to help stop your anaemia returning. This will usually be a tablet, which you'll have to take once a day. 

If treatment is ineffective

If your iron levels don't improve, your GP will ask how regularly you've been taking your iron supplements.

Some people are put off taking the medication because of the side effects. However, your condition won't improve if you don't take the supplements.

If you've been taking the supplements as prescribed and your iron levels still haven't improved, your GP may refer you to a specialist for an assessment.

Complications of iron deficiency anaemia

Iron deficiency anaemia rarely causes serious or long-term complications, although some people with the condition find it affects their daily life.

Some common complications are outlined below.

Tiredness

Iron deficiency anaemia can make you feel tired and lacking in energy (lethargic). This may result in you being less productive at work, and you may find it difficult to stay awake or not feel able to exercise regularly.

Increased risk of infections

Research has shown iron deficiency anaemia can affect your immune system – the body's natural defence system. This increases your vulnerability to infection.

Heart and lung problems

Adults with severe anaemia may be at risk of developing complications that affect their heart or lungs.

For example, you may develop tachycardia, which is an abnormally fast heartbeat, or heart failure, where the heart fails to pump enough blood around your body at the right pressure.

Pregnancy complications

Pregnant women with severe anaemia have an increased risk of developing complications, particularly during and after birth.

They may also develop postnatal depression, which some women experience after having a baby.

Research suggests babies born to mothers who have untreated anaemia are more likely to:

• be born prematurely – before the 37th week of pregnancy
• have a low birth weight
• have problems with iron levels themselves
• do less well in mental ability tests

Restless legs syndrome

Some cases of restless legs syndrome are thought to be caused by iron deficiency anaemia. Doctors often refer to this as secondary restless legs syndrome.

Restless legs syndrome is a common condition that affects the nervous system, and causes an overwhelming, irresistible urge to move the legs. It also causes an unpleasant feeling in the feet, calves and thighs.

Restless legs syndrome caused by iron deficiency anaemia can usually be treated with iron supplements.

Nosebleed: what to do?

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September 1, 2021

Nosebleed, or epistaxis, is an unexpected and even frightening phenomenon.

Should one be alert when such an unpleasant symptom appears, what factors provoke it and how can one help in such a situation? Let's figure it out further. nine0003

Why does the nose bleed?

Bleeding from the nose is classified into "anterior" and "posterior". In the first case, the cause is damage to small blood vessels, this type is usually easy to stop. The second case is considered more dangerous, bleeding occurs due to injury to large vessels located deeper in the nose, so it cannot be dealt with at home. If the blood is "in full swing" - this is a reason for an urgent call for an ambulance.

Causes of nosebleeds include:

• nose injury;
• thinning of the mucous membrane;
• inflammatory processes in the nasal cavity;
• vascular fragility, diseases of the heart and blood;
• sudden increase in blood pressure;
• uncontrolled intake of certain drugs (anticoagulants, NSAIDs, vasoconstrictor drops for the common cold).

What should I do if my nose bleeds?

At the moment when the bleeding starts, it is important to try not to be nervous, because the excitement makes our heart beat faster, which leads to more blood loss. nine0003

The bleeding stop algorithm is as follows:

• Sit straight, tilt your head forward.
• You should be comfortable: loosen the belt and collar, if necessary, open the window.
• Place a cold, wet towel or ice on your nose and a warm heating pad on your feet. This will help constrict the vessels in your nose and dilate them in your legs, which will reduce bleeding.
• Clamp the bleeding vessel: squeeze the wings of the nose with your fingers for 3-5 minutes, the blood should stop. Also for this purpose, you can enter a gauze swab previously moistened with hydrogen peroxide into the nostril. nine0006

If you have completed all of the above and the blood continues to flow, call an ambulance immediately, as even a small loss of blood can lead to fainting.

What to remember about nosebleeds?

• Do not lie down and do not let your feet be above your head - this will increase bleeding;
• Do not tilt your head: a large amount of blood in the stomach can cause vomiting, and blood can flow into the windpipe and make breathing difficult. nine0006
• After the bleeding has stopped, refrain from eating and caffeinated drinks to avoid high blood pressure and new bleeding.

Prevention of nosebleeds

Remember, frequent nosebleeds are a reason to see a doctor. The specialist will identify the cause of the problem and prescribe treatment, which may include the use of hemostatic agents, as well as drugs that improve blood circulation.

To prevent rebleeding, your specialist may recommend:

1. Taking medications and vitamins to strengthen blood vessels.
2. Proper diet. Adding foods rich in vitamin K and C to the menu. Vitamin K is responsible for blood clotting, they are rich in parsley, spinach, basil, bananas, avocados, broccoli, bran, etc. Vitamin C strengthens the walls of blood vessels, it is found in large quantities in rose hips, sweet peppers, currants, citrus fruits, etc.
3. Activity and moderate physical activity: light exercise in the morning, daily walks in the fresh air, swimming pool, etc.

Be healthy!

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This blog is not intended to provide diagnosis, treatment or medical advice. The information on this block is provided for informational purposes only. Please consult your physician for any medical and health-related diagnoses and treatments. The information on this blog should not be considered a substitute for consulting a doctor.

Why does the nose bleed? — GAUZ OZP City Clinical Hospital No. 8

• Post author: Press Secretary
• The entry was published on: 07/24/2019
• Post category: Prevention