Do hot drinks have any effect on the severity or duration of epistaxis?
Date First Published:
January 10, 2015
Last Updated:
January 15, 2015
Report by:
Dr Jennifer Lewis , Foundation Year One Doctor (Northwick Park Hospital )
Search checked by:
Dr Jennifer Lewis , Northwick Park Hospital
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$.mp) OR (hot food.mp) OR (warm food.mp) OR (hot meal.mp))
Limits: English language, Humans
((exp Epistaxis/) OR (epistaxis.mp) OR (nasal bleeding.mp) OR (nose bleed.mp))
AND
((exp Beverages/) OR (exp Hot Temperature/) OR (exp Tea/) OR (exp Coffee/) OR (hot drink$.mp) OR (hot food.mp) OR (warm food.mp) OR (hot meal.mp))
Limits: English language, Humans
Outcome:
12 papers, of which 1 was of interest
Relevant Paper(s):
| Study Title | Patient Group | Study type (level of evidence) | Outcomes | Key results | Study Weaknesses |
|---|---|---|---|---|---|
| Epistaxis after prolonged water immersion in a hot Jacuzzi J Backon Dec-89 Israel | 1 patient case report | A short letter to the editor of the Postgraduate Journal of Medicine which details a patient who developed significant epistaxis after sitting in a hot Jacuzzi for over 90 minutes with only his head exposed. He normally only spent 15 minutes in the Jacuzzi. | Exceptionally small sample size Low quality case report Does not directly link exposure to hot food or drink with epistaxis once it has begun, but recognises that high temperatures may lead to bleeding. |
Author Commentary:
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.
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:
- J Backon . Epistaxis after prolonged water immersion in a hot Jacuzzi