Posterior epistaxis is a less common type of nosebleed that originates from the back of the nose and may require hospital treatment. It can be caused by various conditions and is treated with nasal compress or a double balloon device. Symptoms may include blood running down the back of the throat or anemia, coughing, or vomiting blood.
Posterior epistaxis is bleeding that comes from the back of the nose. It is much less common than anterior epistaxis, which bleeds from the front of the nose. Only about ten percent of cases of epistaxis, or nosebleeds, are posterior. In posterior epistaxis, the amount of bleeding can be quite large and treatment in hospital may be required.
When bleeding comes from the back of the nose, it usually originates from branches of what are called the sphenopalatine arteries in the back nasal cavity. Causes of a posterior nosebleed can stem from the nose itself and can include conditions such as infections, allergies, and injuries. Alternatively, a disease that affects the whole body could cause nosebleeds. Such conditions could include blood clotting disorders, such as hemophilia, or disorders such as liver disease and leukemia.
One of the most obvious signs of a posterior nosebleed is that a doctor can’t find any source of the bleeding in the front of the nose. It can also become apparent when bleeding continues even after a pack has been placed on the front of the nose. If there is blood coming from both nostrils, this may be an indication of a posterior nosebleed, although bleeding from only one nostril may initially occur. Sometimes, because the bleeding is coming from the back of the nose, blood can be seen running down the back of the throat. In some cases, there may be no symptoms of a posterior nosebleed, but in others, anemia, coughing, or vomiting blood or blood in the stool may occur.
Treatments for back nosebleed usually involve the use of a nasal compress, which is placed by an ear, nose and throat specialist. A nasal pack is made from a wad of gauze, and this is maneuvered into place using a flexible tube called a catheter. The catheter is inserted into one nostril before being pushed up the back of the nasal cavity, around and down the throat, and out through the mouth. A gauze pack is attached to the mouth end of the catheter and this is then moved into position by pulling on the nostril end of the catheter until the gauze pack is seated at the back of the nasal passage. Because it seals the opening at the back of the nose and presses on the source of the bleeding, the packet can help stop the bleeding.
An alternative treatment for posterior nosebleed involves using what is called a double balloon device, which is inserted into one nostril. The device is then passed to the back of the nose and a posterior balloon is inflated. This sits at the back of the nasal cavity, stopping blood flow. An anterior balloon is inflated in the front of the nose to anchor the posterior balloon and prevent it from moving down and interfering with breathing.
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