A nosebleed, medically termed epistaxis, occurs when blood vessels in the nasal lining rupture, causing blood loss from the nasal cavities. While seeing blood in the mouth or throat can be alarming, it is a common occurrence after a nosebleed and is usually not a sign of a severe underlying problem.
Why Blood Appears in the Mouth
The nasal passages connect to the throat, specifically the nasopharynx, located directly behind the nose. This connection means blood from a nosebleed does not always exit through the nostrils. Instead, blood can drain backward from the nasal cavity into the throat.
If an individual leans their head back, blood can flow down the back of the throat. This blood may accumulate in the mouth or be swallowed, leading to the sensation of blood in the throat or the need to spit it out. Natural reflexes may also cause individuals to cough up this blood.
When It’s Normal and When to Be Concerned
Spitting out small amounts of blood or blood clots after a nosebleed has stopped is usually normal. This often includes dark blood, which may have been swallowed and partially digested, or blood that has clotted in the nasal passages before draining. Swallowed blood can irritate the stomach lining, potentially leading to nausea or vomiting of dark blood, which is generally expected.
However, certain signs indicate a more serious situation requiring medical attention. Seek care if:
- Bleeding is heavy and continuous, persisting for more than 20 minutes despite direct pressure.
- Large amounts of blood are swallowed or frequently vomited.
- Dizziness, weakness, or fainting accompanies the nosebleed.
- The nosebleed occurs after a head injury.
- Nosebleeds are frequent without a clear cause, or are difficult to stop.
- Nosebleeds are associated with new medications, especially blood thinners, or underlying medical conditions like bleeding disorders or high blood pressure.
Managing Nosebleeds and Associated Blood
When a nosebleed begins, sit upright and lean slightly forward, rather than tilting the head back. Leaning forward helps prevent blood from flowing down the throat, reducing the amount swallowed and minimizing stomach upset. Gently pinch the soft part of the nose, just above the nostrils, for 10 to 15 minutes continuously. Breathe through the mouth during this time. Applying a cold compress or ice pack to the bridge of the nose can also help constrict blood vessels.
Spit out any blood that accumulates in the mouth or throat instead of swallowing it. Once the bleeding has stopped, avoid picking or blowing the nose forcefully for several hours, as this can dislodge clots and restart the bleeding. Gentle care of the nasal passages helps prevent recurrence.
Preventing Future Nosebleeds
Preventative measures can reduce the frequency of nosebleeds, especially for those prone to them. Keeping the nasal passages moist is a common strategy. Use a humidifier, particularly in dry environments or during colder months when indoor air is heated. Saline nasal sprays or gels can also hydrate the nasal lining.
Avoiding trauma to the inside of the nose is important. This includes refraining from nose picking and being gentle when blowing the nose. Identifying and avoiding specific triggers, such as dry air or certain irritants, can also contribute to prevention. If nosebleeds are frequent or recurrent despite these measures, consulting a doctor is recommended to investigate potential underlying causes or receive more specialized advice.