Which disorder is known to worsen epistaxis?

Cirrhosis can lead to worsening epistaxis due to the effects on hemostasis and the liver's inability to produce adequate clotting factors. Patients with cirrhosis often have coagulopathy due to impaired synthesis of these factors, along with potential thrombocytopenia that can result from hypersplenism associated with portal hypertension. This combination can increase the risk of bleeding, including epistaxis, as the body's capacity to form clots is compromised.

While diabetes mellitus can have vascular implications and may lead to other complications, it is not specifically linked to an increased frequency of epistaxis. Hypertension is also a risk factor for hemorrhagic events but does not directly cause epistaxis to worsen. Allergic rhinitis, while it may lead to nasal congestion and can contribute to minor bleeding due to irritation, does not have the same systemic effects on coagulation as cirrhosis does. Thus, cirrhosis is the disorder most directly associated with worsening epistaxis.