Epistaxis (Refractory Nosebleed)

Epistaxis is a nosebleed or bleeding from the tissue lining the inside of the nose. They are not usually serious, unless you have frequent or heavy nosebleeds. Sometimes, the bleeding does not respond to standard measures taken at home. Continued significant bleeding lasting more than 20–30 minutes may necessitate urgent evaluation in a medical setting.

What’s in this section?


Diagnosis starts with a physical exam and medical history. You will be asked about the duration and frequency of your nosebleeds as well as how much blood was lost and if the nosebleed occurred in one or both nostrils. Your nose will be evaluated to determine the origin of the nosebleed and possible causes of it. It is likely you will have already seen an ear, nose and throat (ENT) physician prior to being referred to us.

Treatment options

Things like chemicals, medications, nasal packing or cauterization may be tried. At times, a neuro-interventional procedure is an option. With epistaxis embolization, a flexible catheter (tube) is directed through the blood vessels under x-ray guidance to the area of bleeding. A glue-like material is then injected to seal off the bleeding spot from within the artery.


Request an appointment online and we will guide you through the next steps.