Q: My 4 years old son had nose bleeding about one year ago. His paediatrician said he has a very sensitive nose and bleeding may occur especially after flu.
I’ve been monitoring his condition, and indeed he would have nose bleed after he recovered from flu. However, recently he has nose bleeding fortnightly. Nowadays, he even bleeds twice a day, morning and afternoon!
As a mother, it’s really an alarming and frightening sight and it hurts me to see a young child losing so much blood.
Answer:
Your son with this condition has allergic rhinitis. Children usually have extremely itchy noses and they often rub or pick their noses. The repeated trauma from the rubbing will cause the nose to bleed.
Secondly, nose bleed or epsitaxis is extremely common in children whether or not there is concomitant allergic rhinitis. This is because they have very prominent blood vessels in an area of the nose called the Little’s area. In colder climates and low humidity, many children bleed spontaneously frequently.
Your son needs to be treated for his allergic rhinitis, properly and adequately. He will require an antihistamine and possibly an inhalational steroid for the duration of a few weeks depending on his condition. If his improvement is minimal in spite of the treatment, he needs to be reviewed by the Ear, Nose and Throat surgeon.
During this review, the surgeon will use a small scope to look into his nose and the Little’s area. If a source of bleeding is identified, the blood vessel can be cauterised to curb further bleeding.
Dr Veronica Toh, Specialist in Paediatric Medicine,
Raffles Children’s Centre
This article is provided by Raffles Medical Group. For more information visit https://www.rafflesmedicalgroup.com/
