NOSEBLEEDS IN THE ELDERLY

Nosebleeds, infrequent during most of our adult lives, again become more common after 70. Whereas nasal hemorrhages in children are mostly due to trauma (nosepicking, etc.) and are usually easy to stop, nosebleeds in the elderly usually reflect some more general disturbance and can result in a heavy blood loss. Perhaps the most common cause for nasal bleeding in the elderly Is the combined effect of brittle, hardened arteries and high blood pressure. Although, in most cases, simply squeezing the nose for five minutes usually stops the bleeding, medication to control the blood pressure and cauterization of the bleeding nasal artery are also often needed to prevent recurrences.

Now, according to the British Medical Journal, we should be on the lookout for two additional factors in the elderly. Many elderly people have such poor diets that they become borderline cases of scurvy (vitamin C deficiency resulting in hemorrhages). This can be quickly corrected with ascorbic acid (vitamin C) tablets, one gram daily. Another common factor is the long-continued use of anti-arthritic drugs. Aspirin and most anti-arthritis drugs (with names ending in “-profen”) slow blood clotting and therefore help to cause bleeding. When this is so, treatment with aspirin, etc., may need to be temporarily discontinued and later taken at a lower dose. In some cases, it may be necessary to avoid these drugs entirely.

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