EPISTAXIS (NASAGAT RAKTPITTA): AN INTEGRATIVE REVIEW OF ETIOLOGY, PATHOGENESIS, CLINICAL FEATURES, AND MANAGEMENT IN AYURVEDA AND MODERN MEDICINE

Epistaxis, or nasal bleeding, is a common emergency in otorhinolaryngology affecting individuals of all ages. While many episodes are mild and self-limiting, recurrent or severe cases can present serious clinical challenges and, in rare situations, become life-threatening. Improvements in diagnostic approaches, therapeutic interventions, and clinical guidelines have refined strategies for managing epistaxis effectively. This review critically examines the causes, pathophysiology, clinical manifestations, and management of epistaxis from both modern medical and Ayurvedic perspectives, providing an integrated framework for clinical application. From a contemporary medical standpoint, epistaxis is categorized as anterior or posterior, depending on the source of bleeding. Anterior epistaxis typically arises from the Kiesselbach plexus, whereas posterior bleeding originates from the Woodruff plexus. Contributing factors include local causes such as trauma, inflammation, anatomical variations, and environmental conditions, as well as systemic disorders like hypertension, coagulopathies, and cardiovascular disease. Seasonal variations, particularly low humidity in winter, exacerbate mucosal dryness and increase bleeding risk. In Ayurveda, epistaxis corresponds to Nasagat Raktapitta, characterized by spontaneous bleeding from natural orifices without injury. The condition is primarily linked to vitiation of Pitta Dosha, resulting in Rakta Dhatu dushti and its abnormal upward movement, termed Urdhvaga Raktapitta. Predisposing factors include excessive heat exposure, strenuous activity, emotional stress, and consumption of hot, pungent, sour, or salty foods. Ayurvedic management emphasizes a holistic approach, including Nidana parivarjana, lifestyle and dietary modifications, and specific therapeutic interventions to pacify Pitta and stabilize Rakta. This review underscores the conceptual and clinical correlation between modern epistaxis and Nasagat Raktapitta, highlighting the importance of integrating classical Ayurvedic principles with contemporary medical practices for comprehensive and effective patient management.