Blood flow disorder

Article
2021-01-31

Also known as Hemophilia, Von Willebrand disease, Coagulation Disorders, Coagulation Disorders, Coagulation Factor Deficiencies

Bleeding disorders are rare conditions that affect the way the body regulates blood clotting. If your blood doesn't clot normally, you may have problems with bleeding too much after an injury or surgery. This health theme will focus on bleeding disorders caused by problems with clotting factors, including hemophilia and von Willebrand disease.

Clotting factors, also called clotting factors, are proteins in the blood that work with small cells called platelets to form blood clots. Any problem that affects the function or the number of clotting factors or platelets can lead to a bleeding disorder.

A bleeding disorder can be inherited, meaning that you are born with the condition, or it can be acquired, meaning it develops over your lifetime. Signs and symptoms may include easy bruising, heavy periods and nosebleeds which are common. Your doctor will review your symptoms, risk factors, medical history, and blood test results to diagnose a blood disorder.

Your doctor may recommend medications or clotting factor replacement therapy to treat the bleeding disorder. Some bleeding disorders are lifelong conditions and some can lead to complications. Even if you don't need a medicine to treat the bleeding disorder, your doctor may recommend that you take precautions before a medical procedure or during pregnancy to avoid bleeding problems in the future.

Symptoms

Signs, symptoms, and complications can be different depending on the type of bleeding disorder, the cause, and whether the condition is mild or more severe. Signs and symptoms can become apparent soon after a child is born or as late as adulthood. People with a mild bleeding disorder may not have any signs or symptoms until they are injured or have a medical procedure.

Signs and symptoms of bleeding disorders can include:

Blood in the urine or stool
Excessive bleeding that does not stop with pressure and may start spontaneously, such as with nosebleeds or bleeding after a cut, dental procedure, or surgery
Frequent, large bruises
Heavy bleeding after delivery
Heavy menstrual bleeding, including menstrual bleeding that often lasts longer than seven days or that requires changing pads or tampons more than every hour
Petechiae, or bleeding under the skin that causes small purple, red, or brown spots
Redness, swelling, stiffness or pain due to bleeding in muscles or joints, which is especially common with hereditary haemophilia
Bleeding from the umbilical stump that lasts longer than is typical for newborns - about one to two weeks after the umbilical cord is cut - or that does not stop

Therapy

Treatment for bleeding disorders varies depending on the condition and may include medications and factor replacement therapy. Your treatment may be every day to prevent bleeding episodes, or as needed when you are planning surgery or are in an accident. You may not need treatment if your bleeding disorder is mild.

Your healthcare team

Bleeding disorders affect many parts of the body, so you will need a team of different doctors to provide your care. This includes a hematologist, a doctor who specializes in blood disorders. It can also be a specialist nurse, physiotherapist, and social worker. Depending on the bleeding disorder, you and your healthcare team can create a treatment plan that is best for you.

Medicines

Medicines to treat bleeding disorders may include the following.

Antifibrinolytic agents, such as tranexamic acid, to treat bleeding after childbirth or during procedures such as those involving dental work
Birth control pills for the treatment of heavy menstrual bleeding in women with von Willebrand disease
Desmopressin (DDAVP), a man-made hormone, to treat mild bleeding in haemophilia or VWD.
Immunosuppressant drugs, such as prednisone, to reduce antibody production in acquired bleeding disorders blure. Side effects can include infections and diabetes.
Vitamin K supplement, to treat bleeding from vitamin K deficiency

Factor replacement therapy

Factor replacement therapy is a type of treatment in which clotting factors that come from blood donations or made in a laboratory are given to replace the missing clotting factor. Your doctor may recommend factor replacement therapy if you are experiencing bleeding or to prevent bleeding. Regular treatment with replacement therapy to prevent bleeding is called prophylactic treatment. Prophylactic treatment is usually used for severe bleeding disorders.

Factor replacement therapy can include:

Bypassing medications to treat antibodies. These drugs add other types of clotting factors to help your blood clotting. This treatment can increase the risk of blood clots forming in the blood vessels.
Clotting factor concentrates to replace the missing clotting factor in hereditary bleeding disorders. This treatment can increase the risk of antibody formation in the blood. Sometimes factor concentrates are used in higher doses to treat bleeding disorders related to antibodies.
Fresh frozen plasma, from human blood, to provide clotting factors. It is used for bleeding disorders caused when multiple clotting factors are missing, such as bleeding related to liver disease.

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