What do profuse nasal bleeding, slight headache and discolored stools in a 60 year old indicate?
As the old saying goes: "When it nosebleeds.....it pours!" You say that this nosebleed used a half roll of paper towels which is "extreme for me." This implies that you do suffer from nosebleeds at least on an intermittent basis but this one was particularly heavy.
Typically, nosebleeds can be profuse, voluminous, and downright scary. I don't know if you've ever been to ENT to have the problem looked at but if as you say you are in overall good health, do not use drugs that could cause nasal problems (e.g. cocaine) but you are a smoker then, I would ask if you suffer from the common entity of hypertension. Often times a sudden rise in blood pressure for various reasons can give acute episodes of significant epistaxis (nose bleeding) and the headache may actual be a sign of that acute rise in blood pressure. If you have a blood pressure cuff you should take your pressure and make sure the numbers are not significantly higher than usual.
If they are then, that could easily explain your symptoms and I'd suggest an immediate visit to an ER so they can assess why that might've happened and how to approach treating the pressure if still acutely elevated.
The discolored stool is from your swallowing of blood into your stomach as it passes down through the gut and out the disposal end.
Therefore, my recommendation is that if you are still having any symptoms such as unusual or nagging headaches, ongoing (even if intermittent) nasal bleeding, or other upper respiratory sorts of discomfort would be to go to the nearest ER and tell them all the symptoms. You should drink plenty of fluids and if you have any nasal packing, just go ahead and load up with towelettes into the nasal cavities.
I would also get an appointment with ENT as soon as possible so they can look at your nasal apparatus and do proper studies (blood work, imaging studies, nasoscopy) to make sure you don't have something much less interesting but which can still "bleed like snot!", such as nasal or sinus wall polyps.
Dr. Dariush Saghafi, Neurologist
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