Abnormal bleeding

For a lay person:

Abnormal bleeding means bleeding from somewhere it shouldn't — the nose, gums, lungs, stomach, bowel or urinary tract — or bruising and red-purple spots under the skin without a clear injury.

For a trained medical person:

Evaluation depends on site: epistaxis, haemoptysis, haematemesis or melaena, haematochezia, haematuria, or purpura. Underlying causes range from local lesions and malignancy to thrombocytopenia, coagulopathy and anticoagulant therapy. Haemodynamic assessment comes first.

In Chinese medicine:

Classed under blood patterns (血證). Bleeding is attributed to Heat making the Blood move recklessly (full Heat or empty Heat from Yin Deficiency), to Qi Deficiency failing to hold the Blood, or to Blood Stasis forcing Blood out of the vessels. Maciocia organizes the patterns by site.

When to get help: Get emergency care for vomiting or coughing up blood, black or bloody stools, heavy bleeding that won't stop, or bleeding with dizziness or fainting. Unexplained bruising needs a doctor's assessment.