Bleeding Disorders

A bleeding disorder is a condition that affects the way your blood normally clots. When you get injured, your blood normally begins to clot to prevent a massive loss of blood. Sometimes the mechanism that causes the blood to clot fails, resulting in rapid or prolonged bleeding.

Bleeding disorders don’t always affect blood leaving the body. There are many conditions that cause bleeding to occur under the skin or in the brain.

Bleeding disorders are often caused by a failure of the blood to clot. Several conditions can affect the way the blood clots. Many causes are related to protein defects in the plasma (the liquid component of blood). These proteins are directly responsible for how the blood coagulates (clots). In some diseases, these proteins might be missing completely or they may be low in count. The majority of these defects are hereditary (passed from parent to child through genes). However, some may develop due to other medical conditions.

Other conditions that can cause bleeding disorders are:

• liver disease
• low red blood cell count
• vitamin K deficiency
• medication side-effects

Medications that inhibit the clotting of the blood are called anticoagulants.

There are several bleeding disorders that can be inherited (passed down through genetics) or acquired. Some cause bleeding spontaneously, whereas others cause bleeding following an accident.

The most common inherited bleeding disorders are:

• hemophilia A and B: caused by a deficiency or lack of certain blood clotting proteins, called factors. This disorder causes heavy or unusual bleeding
• factor II, V, VII, X, XII deficiency: relate to blood clotting problems or abnormal bleeding problems
• von Willebrand’s disease: the most common inherited bleeding disorder; caused by a deficiency of von Willebrand factor, which helps blood platelets clump together and stick to a blood vessel wall

Certain diseases or medical conditions can also cause a deficiency of one or more blood clotting factors. The most common causes of acquired bleeding disorders are end-stage liver disease or vitamin K deficiency. According to the American Association of Clinical Chemistry (AACC), this is because most blood clotting factors are produced in the liver, and certain clotting factors are vitamin k dependent (AACC, 2011).

Identification of Bleeding Disorders| Symptoms

The main sign of a bleeding disorder is prolonged or excessive bleeding. The bleeding is normally heavier than normal and unprovoked.

Other signs of a bleeding disorder include:

• unexplained bruising
• heavy menstrual bleeding
• frequent nosebleeds

To diagnose a bleeding disorder, your doctor will go over your medical history. During this part of the exam, the doctor will ask questions about any medical conditions you may have and any medications you may be taking.

Make sure to mention:

• additional symptoms
• how often you experience the bleeding
• how long the bleeding episode lasts
• what you were doing before the bleeding began

After gathering this information, your doctor will administer tests that include:

• complete blood count (CBC): to check the amount of blood loss as well as the amount of red and white blood cells you have)
• platelet aggregation test
• bleeding time: to see how fast your blood vessels close to prevent bleeding

Treatment options vary depending on the cause for the bleeding.

Iron Supplementation

If you have significant blood loss, your doctor may prescribe iron supplements to replenish the amount of iron in your body. A low iron level can result in iron deficiency anemia. This condition can make you feel weak, short of breath, and light-headed. In addition to treatment with iron, you may need a blood transfusion.

Blood Tranfusion

A blood transfusion replaces the lost blood with blood taken from a donor. The donor blood has to match your blood type to prevent complications. This procedure is only offered in the hospital.

Additional treatments include:

• factor replacement
• fresh frozen plasma transfusion

The best outcome results from seeking early treatment. Complications can arise if treatment is sought too late. Complications can also arise if the disorder is severe or causes excessive blood loss.

Common complications of bleeding disorders include:

• bleeding into the brain
• bleeding within the intestines
• bleeding into the joints
• joint pain