Bleeding Disorders

Any person could experience simple or severe bleeding as a result of numerous causes. There are several bleeding-related problems and disorders that could be severe in some cases.

Bleeding disorders

They affect how the body controls blood coagulation and lead to severe bleeding after any surgical procedure or injury, even if it’s simple. Moreover, bleedings could occur on their own sometimes, and their management could be very hard.

The blood consists of plasms (the liquid part), red blood cells (responsible for transporting oxygen), white blood cells (responsible for defending the body against diseases), and platelets (responsible for the coagulation process).

Causes of bleeding disorders

• Problems in the platelets: When bleeding starts, the platelets accumulate in its place and form a clot to stop the bleeding, but when there is a problem in the platelets, this affects the coagulation process and therefore leads to continued bleeding.
• Problems in the plasma’s proteins: The plasma contains several important and essential proteins for the coagulation process, so any problem in these proteins affects the coagulation process.

Types of bleeding disorders

The reason for the bleeding could be congenital (inherited), a specific disease, or other causes (medicines, surgical procedures, etc.).

Congenital (inherited) bleeding disorders

• Von Willebrand’s disease: It’s a common congenital bleeding disorder that’s resulted from a problem in one of the genes that we inherit from our parents (mutation), which leads to problems in the coagulation and abnormal bleeding.
• Hemophilia: It has three types (hemophilia A, which is the most common, B, and C), and it’s an inherited disease as well and leads to severe bleeding. It mostly occurs in males.

Acquired bleeding disorders

• Disseminated intravascular coagulation (DIC): It’s a multi-system disorder that leads to bleeding and thrombosis in the microvasculature. It occurs as a result of life-threatening conditions like sepsis and massive trauma (like strong injuries, accidents, etc.).
• Immune thrombocytopenic purpura (ITP): It’s an autoimmune disease in which the body itself attacks the platelets and destroys them, and that leads to severe bleeding.
• Thrombotic thrombocytopenic purpura (TTP): It occurs as a result of platelet clumping in the microcirculation, which leads to thrombocytopenia and other very serious complications.

Qualitative disorders of platelets

Platelets, associated with coagulation factors, are responsible for clot formation and stopping bleeding when it exists. Therefore, any problem with the platelets will definitely affect the coagulation process and lead to abnormal bleeding.

Liver diseases

The liver is where most of the coagulation proteins are synthesized, so when a problem occurs in the liver, this might affect the synthesis of these proteins and lead to a bleeding disorder.

Symptoms of bleeding disorders

• Heavy bleeding even in simple injuries and after surgical procedures.
• Many big bruises.
• Bleeding in the joints and muscles leads to redness and pain at the site of the bleeding.
• Blood in the urine or stool.
• Heavy bleeding during the menstrual period.
• Heavy bleeding after giving birth.
• The appearance of petechiae results from bleeding under the skin, and they’re small red or brown spots.
• Nosebleeds that don’t stop easily.

Diagnosis of bleeding disorders

• Medical history of the patient and family history.
• Physical exam.
• Blood tests.
• Specific tests for the platelets and coagulation factors.
• Looking for other conditions that cause bleeding.

Treatment of bleeding disorders

It depends on the causative factor and the severity of the bleeding. Mild symptoms might not require any management or treatment.