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Three Part Question

In [patients with spontaneous epistaxis] does [drinking hot drinks or eating hot food] make any difference to the [severity or duration of bleeding]?

Clinical Scenario

A 46 year old lady attends the Emergency Department with significant epistaxis from the right nostril - this started spontaneously. Her nose is packed using a Rapid Rhino. She feels better and would like a hot cup of tea - you know the policy is to avoid hot food and drink for 24 hours to prevent further bleeding, however you would if there is any evidence to support this?

Search Strategy

Ovid MEDLINE(R) In-Process & Other Non-Indexed Citations, Ovid MEDLINE(R) and Ovid OLDMEDLINE(R) 1946 to Present

((exp Epistaxis/) OR (epistaxis.mp) OR (nasal bleeding.mp) OR (nose bleed.mp))

AND

((exp Beverages/) OR (exp Hot Temperature/) OR (exp Tea/) OR (exp Coffee/) OR (hot drink$.mp) OR (hot food.mp) OR (warm food.mp) OR (hot meal.mp))

Limits: English language, Humans

Search Outcome

12 papers, of which 1 was of interest

Relevant Paper(s)

Author, date and country	Patient group	Study type (level of evidence)	Outcomes	Key results	Study Weaknesses

Comment(s)

This paper is a short letter to the editor briefly detailing the link between hot water and epistaxis. The links between increased temperature and dilatation of blood vessels is well known and therefore common sense would suggest that hot drinks would dilate the vessels in the nose - hence worsening epistaxis. However there does not appear to be any papers which detail a link between eating hot food or drinking hot beverages immediately after or during epistaxis.

Clinical Bottom Line

As there is no evidence for this clinical scenario it is sensible to continue with the current practice and advise epistaxis patients to avoid from hot food and drink. If ethical complications and a suitable study format could be created then further research into this matter may provide more information.

References

1. J Backon Epistaxis after prolonged water immersion in a hot Jacuzzi Postgraduate Medical Journal 65(770):958, 1989 Dec