It was a typical morning. My mother was getting ready; this was her usual routine: bustling around the house. When she suddenly stopped and shouted, blood was oozing from her nose. As kids, my siblings and I were terrified. We scrambled to help, but it wasn't until later that we learned the cause of that alarming moment: high blood pressure. That day was our first lesson in the silent yet powerful effects of hypertension. Nosebleeds, or epistaxis, are common, and nearly everyone experiences at least one in their lifetime.

While most are minor and often caused by dry air or irritation, some can signal underlying health concerns. One recurring question is whether high blood pressure causes nosebleeds or is merely coincidental.

Where Exactly Does a Nosebleed Occur?

The nose is covered by a rich plexus of small blood vessels, making it prone to bleeding. Most nosebleeds are anterior in origin, occurring at the front of the nose, and are relatively benign. They often occur because of irritants such as dry air, frequent nose-blowing, or trauma.

On the other hand, posterior nosebleeds are caused by a source that is located deeper within the nasal cavity. They are less common but more severe, as the blood tends to flow backward into the throat, making them more difficult to control. Common causes of posterior nosebleeds include trauma, medical conditions, or high blood pressure.

Connection Between Nosebleeds and High Blood Pressure

Hypertension is the condition whereby the pressure of blood against the arterial walls is consistently too high. Over time, this may damage the fine blood vessels in the nose, causing them to rupture more easily.

Significant studies have shown a strong relationship between hypertension and severe cases of nosebleeds necessitating urgent care. A certain study showed that patients diagnosed with high blood pressure had 2.7-fold increased chances of having nosebleeds that were not slight.

However, it should be noted that mild hypertension by itself does not cause nosebleeds. Nosebleeds are more likely to happen during a hypertensive crisis when the blood pressure suddenly rises to above 180/120. A hypertensive crisis can also have other symptoms such as a severe headache, shortness of breath, and anxiety. Therefore, it is considered a medical emergency.

Why Does Hypertension Increase the Risk?

Chronic hypertension makes the walls of blood vessels weaker and less elastic, which easily causes them to tear. In the nose, this is especially vulnerable because the blood vessels are close to the surface. Sudden surges in blood pressure, such as in a hypertensive crisis, can cause tears in these weakened vessels, resulting in nosebleeds.

While hypertension is a contributing cause, nosebleeds occur infrequently as the only manifestation of high blood pressure. This makes regular monitoring for blood pressure all the more crucial, as hypertension has the reputation of being the "silent killer" since people often do not present symptoms until the disease has run its course.

Other Causes of Nosebleeds

• Dry Air: Cold weather or house heating dries out membranes that line the nose, hence susceptible to cracking.
• Trauma: Blows in the nose, nose picking or excessive nose blowing can traumatize blood vessels.
• Intrinsic Disease: Liver disease and kidney disease and drug therapy that affect clotting such as blood thinners enhance the risk of nose bleeding.
• Foreign Bodies: Children especially tend to insert objects up their noses, which can be irritating and bleed.
• Allergies or Infections: Chronic nasal inflammation resulting from allergies or colds causes irritation to the nasal mucosa.

Managing Nosebleeds at Home

For most nosebleeds, you can manage them yourself at home:

1. Sit up and lean slightly forward to prevent swallowing blood.

2. Press your nostrils together for at least 10 minutes.

3. Use a cold compress on the bridge of your nose to constrict blood vessels.

4. If the bleeding continues, use a nasal decongestant spray.

Consult a doctor if the bleeding persists beyond 20 minutes, is heavy, or follows a head injury.

Preventing Nosebleeds

Preventive measures can decrease the incidence of nosebleeds:

• Use a humidifier to maintain moisture in the air.
• Apply saline sprays or gels to keep nasal passages hydrated.
• Avoid nasal trauma by being gentle when blowing your nose.

For patients with hypertension, managing blood pressure is the best way to minimize the risk of complications. A combination of lifestyle changes, such as maintaining a healthy diet, regular exercise, and prescribed medications, can help keep blood pressure in check.

When to Worry About Nosebleeds

Most nosebleeds are harmless, but they can sometimes be signs of an underlying health condition. In adults with high blood pressure, frequent or severe nosebleeds should never be ignored. A health provider should be consulted in order to rule out any serious conditions and ensure appropriate treatment.

Regular check-ups, a healthy lifestyle, and awareness about the relationship between nosebleeds and high blood pressure would go a long way to protect your health. Indeed, prevention is always better than cure.

Epistaxis and hypertension. Post Graduate Medical Journal. 1977

When a sharp, stabbing stomach pain hit 39-year-old Krystal Maeyke, she attributed it to an allergy or working too hard as a mom. Active, healthy, and fit, the mother of one did not think of herself as vulnerable to cancer—until symptoms could no longer be denied.

Three months after that, Maeyke was diagnosed with stage 4 metastatic bowel cancer, a fact that put her world into disarray and is now a warning to young adults around the world: cancer doesn't care how fit or healthy you look or feel. Even though she was "super healthy and fit," Krystal's experience is a wake-up call that cancer doesn't discriminate on the basis of age, fitness, or family history. Her experience, honestly filmed on TikTok, is now prompting tens of thousands to see and respond to the tricky, much-misunderstood signs of bowel cancer.

Krystal's nightmare started with what she thought were harmless symptoms—sharp, stabbing pains in the lower abdomen. Similar to many, she credited them to an assumed food allergy or irritable bowel syndrome (IBS), particularly given that she was otherwise healthy and had no history of cancer in her family. For three months, she dismissed the discomfort as a result of the demands of motherhood and an active lifestyle. But the symptoms didn't end there. Krystal remembers having:

Recurring, inexplicable night sweats: So bad that she would wake up soaked, having to change clothes and sheets several times throughout the night.

Chronic fatigue: She was exhausted all day, all the time, but wrote it off as the unavoidable exhaustion of being a working mom.

Loss of appetite and abnormal bowel habits: She experienced changes in digestion, but attributed them to diet or stress.

General malaise: A sense of illness that she couldn't put her finger on.

These signs, she later discovered, were the classic prodrome of bowel cancer. But since they were mild, non-specific, and readily explainable by less serious causes, Krystal—like many others—dismissed them until the pain was excruciating.

"I was experiencing stabbing pains, very fatigued, night sweats, loss of appetite, spastic bowel movements, and just off in general," she explained in an open TikTok video chronicling her diagnosis. Like many others, she wrote it off as stress, a busy life, and maybe food intolerance.

She had never thought that these symptoms might be indicative of something potentially deadly.

Some evenings I would wake up sweating and need to change my clothes and bedding. But it was summer, and I had the air conditioner on, so I figured the room wasn't cold enough.

The turning point came when Krystal’s pain reached an intensity she could no longer manage. Living in the remote Australian desert town of Yulara, she was airlifted 280 miles by the Royal Flying Doctors Service to Alice Springs Hospital. There, a battery of tests revealed the unthinkable: stage four metastatic bowel cancer. The cancer had spread beyond her bowel to her abdomen, liver, and ovaries.

Krystal remembers the incident clearly, "I was awoken later that night by a doctor whose words I will never forget. 'Krystal, I've got bad news… You have cancer.' The gravity of those words, coupled with my question of 'How do you know?' and the doctor's reply, 'It's everywhere,' shook me to my core."

What is Advanced Bowel Cancer?

Stage four, or metastatic, colorectal cancer implies the disease has invaded distant organs. The Cleveland Clinic describes this as the most advanced and hardest-to-treat stage. Krystal's case is not unusual: many patients, particularly younger ones, are diagnosed late because early signs are indistinct or mistaken for less severe conditions.

Krystal's case highlights an important reality: bowel cancer can develop and spread viciously, even for those who look reasonably healthy. She experienced every stabbing pain as the tumour developed, almost clogging her bowels, and subsequently noticed a lump she was aware of was not an innocent lymph node, but a tumour.

I was awakened by a doctor whose words I'll never forget," she said. "'Krystal, I've got bad news… You have cancer.' When I asked him how he knew, he said, 'It's everywhere.'

Stage 4 bowel cancer, or metastatic colorectal cancer, is when the cancer has spread to other parts of the body away from the colon or rectum—usually to the liver, lungs, or ovaries. In Krystal's situation, tumors were located throughout her abdomen, liver, ovaries, and bowel. She suspects the constant stabbing pains were because tumors were compressing the important organs and nerves.

"I could feel each stabbing pain," she said. "The tumor was halfways blocking my bowels. I could feel the lump, which they informed me could be merely a lymph node—it was the tumor. And then I could feel it reach my ovaries."

Why Are Younger People at Risk?

A recent study by Cancer Research UK and international studies have pointed to a concerning trend: bowel cancer diagnoses are increasing among individuals under the age of 50. For 27 of 50 countries, cases of early-onset have grown, with young adults diagnosed 23% more in some age brackets. The recent passing of social media personality Tanner Martin at the age of 30 has further focused attention on this concerning trend.

What is perhaps most shocking about Maeyke's story is how many of her symptoms are so typical, non-threatening complaints—tiredness, irregular bowel movements, night sweats that occur with the rise in temperature. With no known family history of cancer, exercising regularly and having a well-balanced diet, she had every reason to assume she was healthy.

But as Krystal's case highlights, bowel cancer is striking younger and younger adults, and the initial symptoms are usually not recognized or misdiagnosed.

Krystal's case is an impassioned plea to act. If you have persistent, unexplained symptoms—most importantly, abdominal pain, night sweats, or alteration in bowel habits—do not brush them aside. Seek advice from a doctor and push for extensive testing if symptoms remain.

Early diagnosis is key: although only slightly more than half of bowel cancer sufferers live 10 years after diagnosis, prognosis is so much better if the disease is diagnosed early. Screening and knowing the symptoms can help save lives.

In the United States, the second most common cause of cancer mortality, colorectal cancer, has seen its diagnoses in people below 50 years surge dramatically over the past few years. Scientists are yet to figure out why—citing processed food, inactive lifestyles, environmental pollutants, and even microplastic exposure as probable culprits.

The passing of 30-year-old influencer Tanner Martin from colon cancer last year pushed the issue further to the forefront, prompting discussions around early screening and education.

Recognising Symptoms of Bowel Cancer

The symptoms of bowel cancer may be challenging to identify in its early stages, Cancer Research UK and the Cleveland Clinic say. Some common symptoms include:

• Rectal bleeding or blood in the stool
• Changes in bowel movements (constipation or diarrhea)
• Fatigue or shortness of breath
• Abdominal pain or bloating
• Unexplained weight loss
• A lump in the abdomen

Yet, many patients show no symptoms until the cancer has already progressed—underscoring the need for vigilance and proactive screening.

Since her diagnosis, Krystal has undergone multiple rounds of chemotherapy and shares her cancer journey with over 50,000 TikTok followers, aiming to raise awareness and offer support to others facing similar battles.

One of her biggest worries, she says, isn't the disease itself—but the psychological cost on her young son, Maison.

"He longs for my warmth, my guidance, and my love—a love that cancer is stealing away," she wrote in a heartbreaking post.

But she's still dedicated to raising awareness. Her tip: "Take symptoms seriously. Night sweats, pain, fatigue—don't ignore them. Trust your instincts. Early detection might just save your life."

'Diagnostic Anomaly' is a Health And Me Series, where we dive deep into some of the rarest of rare diseases. Here, we trace such diseases and what causes them. We also try to bring case studies around the same.

Before biologist Silvana Santos set foot in Serrinha dos Pintos, a remote Brazilian town tucked into the mountains of Rio Grande do Norte, families had long lived with unanswered questions. As BBC reports, the children there were losing the ability to walk, often before reaching adulthood. No one knew why—until Santos arrived more than two decades ago and uncovered a genetic mystery that would put the town on the global medical map.

A Name for the Nameless

With fewer than 5,000 residents, Serrinha dos Pintos had long operated as a close-knit, self-contained community. But beneath the surface of everyday life was a recurring pattern: a growing number of children unable to walk, gradually losing strength in their limbs.

When Santos, a geneticist from São Paulo, arrived for what was meant to be a short holiday, she didn’t just see a town—she saw a puzzle.

That puzzle led her to discover and name Spoan syndrome, as BBC reports, a previously unidentified genetic disorder that weakens the nervous system and affects motor control. It only develops when both parents carry the mutated gene, a scenario made more likely in Serrinha due to a high rate of intermarriage within extended families.

The Town Where Family Ties Run Deep

In Serrinha, it’s common for cousins to marry—a reflection of the town’s geographic isolation and cultural traditions. Santos’s early studies found that more than 30% of couples in the town were related, and a significant number of these unions had produced at least one child with a disability.

Worldwide, cousin marriages are not uncommon, but they come with higher genetic risks. In Brazil, such marriages account for only 1–4% of unions, compared to over 50% in countries like Pakistan. While most children born to cousin couples are healthy, the chance of recessive genetic disorders, like Spoan, doubles to about 5–6% per pregnancy.

From Diagnosis to Global Discovery

Santos’s investigation didn’t end with just a diagnosis. What began as a three-month field visit evolved into years of research.

She drove thousands of kilometres, collected DNA samples door-to-door, and documented family trees over coffee and conversation. Her work culminated in a groundbreaking 2005 study that identified Spoan syndrome and traced its genetic roots.

The syndrome, she found, was caused by the loss of a tiny fragment of a chromosome, triggering a malfunction in brain cells. While local legends pinned the condition on a randy ancestor named Maximiano, genetic evidence suggests the mutation arrived over 500 years ago with European settlers—most likely Sephardic Jews or Moors fleeing the Inquisition.

To date, 83 cases have been confirmed globally—including two in Egypt—strengthening the theory of a shared Iberian ancestry.

Changing the Conversation Around Disability

Santos’s discovery didn’t just change medical records; it reshaped local attitudes.

Once dismissed with slurs like “crippled,” residents with Spoan are now recognised by name, their condition understood with empathy and scientific clarity. Many have received motorised wheelchairs and occupational therapy, improving not just mobility but also dignity.

For Inés, whose two sons are among the oldest living Spoan patients in the town, the transformation is bittersweet. “We love our children the same,” she says, “but we suffer for them.” By age 50, most Spoan patients require full-time care.

A Way To Go Ahead

While a cure for Spoan remains distant, education and awareness are proving powerful tools. Santos is now part of a major government-backed initiative to genetically screen 5,000 couples for risk of recessive diseases. The goal isn’t to discourage cousin marriages, but to provide informed choices for families like Larissa and Saulo—who only discovered they were distantly related after months of dating.

Santos, now a university professor, continues to lead a genetics education centre and remains deeply involved in outreach in Brazil’s northeast. She may no longer live in Serrinha, but to locals, she’s more than a scientist.

“She’s family,” says Inés.

Returning to shared spaces—like schools or offices—also means returning to public restrooms. For some individuals, this transition comes with more than just minor discomfort. The anxiety around using public toilets, especially for defecation or urination, can be so intense that it interferes with daily functioning. This condition is medically recognized as parcopresis (shy bowel syndrome) and, in some cases, paruresis (shy bladder syndrome).

What Is Shy Bowel and Shy Bladder Syndrome?

Parcopresis refers to the difficulty or inability to defecate in the presence of others, especially in public restrooms. Similarly, paruresis describes the difficulty in urinating under similar circumstances. These conditions are not simply a preference for privacy—they are marked by psychological and physiological barriers that inhibit normal bodily functions.

Individuals with parcopresis often find themselves unable to initiate or complete a bowel movement unless they are in a perceived safe, private, and predictable environment, typically at home. The same applies to paruresis, where individuals may only be able to urinate in the comfort of familiar surroundings.

In public or semi-public restrooms, anxiety can trigger the sympathetic nervous system—the body’s fight-or-flight response—which disrupts the relaxation of pelvic muscles required for urination or defecation. As a result, individuals may freeze mid-process, feel pressured to rush, or avoid the restroom altogether, leading to discomfort or medical complications such as constipation or urinary retention.

The Psychological Link

Both shy bladder and shy bowel syndromes are linked to social anxiety disorder. The fear is not necessarily of the act itself but of being heard, judged, or perceived negatively by others. This can create a feedback loop: the more one worries about not being able to go, the harder it becomes.

Over time, this anxiety can escalate to significant social avoidance. People may plan their day around access to private restrooms, avoid travel, limit hydration or food intake, and even decline job opportunities or social engagements. In severe cases, this avoidance behavior can lead to agoraphobia—a fear of being in places where escape might be difficult.

Possible Contributing Factors

While psychological in nature, these syndromes may be more pronounced in individuals with pre-existing physical conditions. For instance, inflammatory bowel disease, irritable bowel syndrome, urinary tract infections, or prostate conditions can exacerbate restroom-related anxiety due to urgency or frequency, increasing the likelihood of distress in public settings.

Management and Treatment

Despite the challenges, both conditions are treatable. The first step is a medical evaluation to rule out or address any underlying physical health issues. Once physical causes are excluded or managed, psychological approaches become central to treatment.

Cognitive-behavioral therapy (CBT) is considered the gold standard. It helps individuals identify and challenge negative thought patterns and gradually exposes them to anxiety-inducing situations—a process known as exposure therapy. In this case, it may involve slowly increasing comfort with public restroom use.

Relaxation techniques, including deep breathing and mindfulness, can help regulate physiological responses to anxiety. In some cases, short-term use of anti-anxiety medications may be recommended to support behavioral therapy.

With the right interventions and support, individuals affected by shy bladder or bowel syndromes can regain confidence and return to normal daily functioning—including using public restrooms without distress.