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Nosebleeds and Hepatitis C

Nicole Cutler L.Ac.

June 16, 2011

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Everyone gets an occasional nosebleed, but those with Hepatitis C may not only be more prone to them – they also must be aware of the potential for spreading the infectious Hepatitis C virus.

Capable of transmitting the Hepatitis C virus, exposing other people to infected blood can be a source of great anxiety for individuals with this infectious disease. For those who do not participate in high risk activities – like sharing intravenous drug equipment – there are few times when exposure to blood occurs. That is unless you consider nosebleeds, an event with the capability of exposing anyone in your near vicinity to infected blood. Complicating matters, those with advanced Hepatitis C appear to be more vulnerable to nosebleeds than others. For people who have the Hepatitis C virus, knowing how to prevent nosebleeds, and how to stop them once they start, can make them far less worrisome.

Epistaxis, known more commonly as a nosebleed, can be scary. Nosebleeds happen for different reasons, such as:

  • living in or visiting high altitudes
  • cold and dry climates
  • exposure to smoke
  • being hit on the nose
  • hard sneezing or nose-blowing
  • high blood pressure
  • abnormal structure in the nose (such as a nasal polyp)
  • platelet disorders

If one or more of these causes exist, nosebleeds may occur more frequently than usual.

About 90 percent of nose bleeds occur at a place inside the nose called Kasselbach’s area, located on the front and lower part of the middle nose bone. This area is susceptible to nose bleeds for several reasons:

  • Four arteries intersect here.
  • Blowing the nose increases the amount of blood in this area.
  • This area is most likely to be stretched by rubbing the nose or scratched by itching the nose with a finger or a tissue.
  • This area is the driest place in the nose, because air from outside enters the nose here and removes water from the tissue.

Thus, the mucosal lining in Kasselbach’s area can more easily be cracked or torn open, resulting in a nosebleed.

Individuals with advanced Hepatitis C are especially prone to frequent and severe nosebleeds because of the liver damage they may have sustained. One of the liver’s many responsibilities is to produce factors needed for blood clotting. Since a liver with impaired function is less able to produce these clotting factors, they are more likely to have and take longer to stop a nosebleed.

You can’t always prevent a nosebleed, but the following steps could help reduce their
recurrence:

  • Open your mouth when sneezing so air can escape through the mouth instead of the nose.
  • Use a humidifier for the air and petroleum jelly or vitamin E oil on the inside of the nose to keep Kasselbach’s area moist.
  • Avoid picking your nose, lifting heavy items and straining during a bowel movement.
  • Work with a physician to control high blood pressure.

If your nose is bleeding, stopping its flow is a priority, not only to prevent blood exposure to those around you, but also to prevent a drop in your blood pressure. The first thing to realize during a nosebleed is not to be afraid. Then:

  • Sit up and lean forward with your mouth open. In this position, you can spit out any blood instead of swallowing it – which could cause nausea and vomiting.
  • Pinch the soft part of your nose together between the thumb and index finger for at least five minutes. Repeat as necessary until the bleeding stops.
  • Apply crushed ice or similar cold pack to the nose and cheeks.
  • Frequent bleeders may want to consider carrying Nosebleed QRTM – or a similar product – which is an over-the-counter topical powder that retards bleeding when applied directly to the nostril with a special swab.
  • Once the bleeding stops, refrain from picking or blowing your nose and breathe through your mouth for a while.

Because the blood of someone with Hepatitis C has the potential to be hazardous to others, these suggestions help those with the virus be responsible. If you do have a nosebleed:

  • Assure those around you that you can apply pressure to your own nose.
  • If someone is there to help, ask them to bring you what you need (ice, tissues, washcloth) – and request a bag to put the soiled remnants into.
  • After the bleed, wash your hands thoroughly and oversee proper cleaning of any blood with a bleach solution or laundering in hot water and bleach.

Despite their commonality, nosebleeds are never a welcome event. For people with Hepatitis C, the likelihood of a nosebleed is not only greater than usual, but it also raises the concern of exposing others to the virus. By taking steps to prevent frequent nosebleeds, knowing how to stop them once they begin and being responsible about the infectivity of Hepatitis C, those with the virus can be less afraid of an occasional nosebleed.

References:

http://www.hemaware.org/story/all-about-nosebleeds, All About Nosebleeds, Nick Kolakowski, Retrieved February 6, 2011, National Hemophilia Foundation, 2011.

http://www.integrative-healthcare.org/mt/archives/2007/06/nosebleeds_101.html, Nosebleeds 101, Nicole Cutler, L.Ac., Retrieved February 6, 2011, Natural Wellness, 2011.

http://www.wellsphere.com/allergies-article/how-can-you-stop-nose-bleeds/770979, Neil Kao, MD, Retrieved February 6, 2011, Wellsphere, 2011.

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Posted by Nicole Cutler L.Ac. on June 16, 2011

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