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Several very heavy nose bleeds including large clots. High cholesterol can do this?

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I have had several very heavy nose bleeds (including large clots) over the last few weeks. I have normal blood pressure and have not suffered any injury to my nose. I have been diagnosed with high bad cholestorel however. Could this be related?
Posted Sat, 16 Jun 2012 in Ear, Nose and Throat Problems
Answered by Dr. Sumit Bhatti 2 hours later

Thank you for your query.

1. I am assuming that you have bleeding from both nostrils. Do you get any bleeding or pass any clots through your throat and mouth? If the bleeding is from both sides, general causes must be ruled out. It is good to hear that your blood pressure is normal. Keep a check at regular intervals. A Coagulogram must be done to check bleeding and clotting parameters. The Hemoglobin levels will give an estimate of the severity of bleeding. A Complete Blood Count will help rule out blood disorders and estimate the Platelet Count. Medication such as ethamsylate, tranexamic acid and Vitamin K may be started under medical supervision. A Nasal endoscopy may help in locating the bleeding points which may be cauterized. Do you have any headache or fever? Has there been any recent nasal trauma? Have you ever required any nasal packing to stop the nasal bleeds? How do you normally tackle them?

2. If the bleed is from only one side, you must get a nasal endoscopy and a CT PNS (Para Nasal Sinuses) to rule out any bleeding mass.

3. A high bad cholesterol will not be directly related to nose bleeds (epsitaxis). Are you on any blood thinning medication?

4. Kindly let me know the results of your investigation for further treatment options.

I hope that I have answered your queries. If you have any further questions, I will be available to answer them.

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Follow-up: Several very heavy nose bleeds including large clots. High cholesterol can do this? 19 hours later
The bleeding starts from one side and seems to go to the other side but the blood is never as thick. Yes, the bleeding does come through the mouth.

My sister has haemachromatosis which I believe can be hereditary. Could this be a factor?

Answered by Dr. Sumit Bhatti 4 hours later

Thank you for writing back.

1. You should get a nasal endoscopy done, preferably immediately during or just after an episode of nasal bleeding.

2. Discuss this with your doctors. The side from which the bleeding seems to originate must be examined first. Blood coming from the other side and mouth may signify a more posterior nasal bleed.

3. The blood from the other side is thinner because it may be mixed with secretions and is partially clotted by the time it reaches the other side and throat .

4. Haemochromatosis is a common genetic predisposition. It may be related to epistaxis (nasal bleeding). Liver Function Tests, a Coalgulogram, other routine blood tests and an Abdominal Ultrasound (USG) will be required to ascertain the role of this factor.

If you have any further questions, I will be available to answer them.

Above answer was peer-reviewed by
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