instruction: hi doctor I currently have recurrent epistaxis this has started since four years on a yearly basis to a daily basis since six months I have been seeing an ent consultant but due to couid 19 I am unable to see him until august I had recent blood tests and mri which came back all clear I had an endoscopic examination that said there was some crusting on the left side and rest all fine believing it is posterior and not anterior epistaxis this is affecting the quality of my life I have also developed bruxism and end with blocked ears now and then I have also got gingivitis as well no hayfever or allergies I am aware of I have had suspected sinusitis but this was not confirmed but every day I have a watery eye especially on the right eye
output: hello welcome to icliniq com you have recurrent epistaxis and you have been cauterized also a number of times there does not seem to be any obvious pathology on examination by endoscopy I must point out that epistaxis can be idiopathic in more than 50 patients this is because certain patients tend to have nasal mucosa far more friable than others and susceptible to even most trivial trauma like nose picking or forceful blowing even minor colds can cause epistaxis however one has to be careful to rule out other causes hypertension is an important cause but that is usually an affliction of elderly at your age one would like to rule out bleeding diathesis did you ever have bleeding from any other site have you done a coagulation profile though you have mentioned blood tests what about liver and renal function tests are you on any medication other than this further deviated nasal septum with spurs can cause epistaxis did mri mention anything like that in case there is nothing to suggest any underlying cause it is likely to be idiopathic and role of precautions become all that necessary one important thing is to prevent your nose from becoming dry as occurs in dry weather and colds you can use liquid paraffin nasal drops to prevent mucosa from becoming dry and friable further you need to avoid blowing hard or frequent cleaning of nose you can also use topical decongestant like xylometazoline 02 if you develop a bleed avoid using them for more than seven days at stretch you can go for a it computed tomography nose and pins para nasal sinus for having a better information on sinus details