Hepatic Failure :
In severe cases of hepatic or liver failure due to conditions like cirrhosis, Epistaxis can occur along with other symptoms of jaundice, altered sensorium, and hematemesis (vomiting of blood). Here the main cause of bleeding is due to increased portal hypertension.
Bleeding Disorders :
Bleeding disorders are a group of disorders in which there is an inability for the blood to clot. Diseases like hemophilia, von willebrand’s disease and disseminated intravascular coagulation belong to this group. Patients with bleeding disorders present with bleeding from orifices following any trauma, injury, surgery or menstruation. These can also present with an unexplained nosebleed.
Drug induced Epistaxis :
Use of certain drugs like aspirin, NSAIDs (Non-steroidal anti-inflammatory drugs), warfarin, and heparin are known to have blood thinning properties and can cause bleeding from nostrils.