30 Mar Bleeding Disorders: What You Need to Know

Bleeding disorders are a group of medical conditions that impair the blood’s ability to clot properly. This can result in excessive or prolonged bleeding, even from minor injuries or cuts.

While some bleeding disorders are genetic and present from birth, others may develop later in life due to medical conditions or lifestyle factors. Understanding the various types of bleeding disorders and their symptoms is important for effective diagnosis and management.

Statistics

• Hemophilia A and B affect approximately 20,000 individuals in the United States, with about 80% of cases being classified as severe
• Bleeding disorders can occur in individuals of any race or ethnicity, but some disorders are more prevalent in certain populations
• For example, hemophilia A is more common in individuals of European descent,
• Hemophilia B is more common in individuals of African descent
• Women with bleeding disorders may experience heavy menstrual bleeding
• 1 in 5 women with heavy menstrual bleeding having an underlying bleeding disorder
• Acquired bleeding disorders, such as those caused by medications or medical conditions, are also relatively common
• Up to 3% of individuals taking anticoagulant medications may experience bleeding complications
• Bleeding disorders can be life-threatening if not properly managed
• Between 400,000-600,000 individuals worldwide have hemophilia
• Without proper treatment, up to 75% of individuals with severe hemophilia may die from bleeding complications before reaching adulthood

How many types of bleeding disorders are there?

There are numerous different bleeding disorders, but the most common are

• Hemophilia A and B
• Factor II, V, VII, X, or XII deficiencies
• von Willebrand’s disease

Acquired bleeding disorders include

• Disseminated intravascular coagulation (DIC)
• Liver disease-associated bleeding
• Vitamin K deficiency bleeding

Hemophilia

One of the most well-known bleeding disorders is hemophilia. Hemophilia is an inherited disorder that affects mostly males and results from a deficiency in clotting factors. The severity of hemophilia can vary depending on the level of clotting factor deficiency.

Symptoms of hemophilia

Individuals with severe hemophilia may experience spontaneous bleeding into their joints and muscles, while those with mild hemophilia may only experience bleeding after an injury or surgery.

Other symptoms include

• Bleeding into the joints
• This can cause swelling and pain or tightness in the joints
• It often affects the knees, elbows, and ankles
• Bruising easily and frequently
• Bleeding of the mouth and gums
• Bleeding that is hard to stop after losing a tooth
• Bleeding after having shots, such as vaccinations
• Bleeding in the head of an infant after a difficult delivery
• Blood in the urine or stool
• Frequent and hard-to-stop nosebleeds

The three types of hemophilia

There are three types of hemophilia: Hemophilia A, Hemophilia B, and Hemophilia C.

• Hemophilia A is the most common type and occurs when you don’t have enough clotting factor VIII
• Hemophilia B—also known as “Christmas Disease” (not because of the holiday; it was named after 5-year-old Stephen Christmas back in 1953)—occurs when you don’t have enough clotting factor IX
• Hemophilia C is a mild form of hemophilia that happens when you don’t have enough clotting factor XI

Individuals with these subtypes of hemophilia may experience similar symptoms as those noted above. The severity runs from type A being most severe to type C being least.

von Willebrand Disease

von Willebrand disease (VWD) is another genetic bleeding disorder caused by a deficiency or dysfunction of the von Willebrand factor, a protein that helps blood clot.

VWD is the most common inherited bleeding disorder.

The symptoms associated with VWD are similar if not the same as the symptoms of hemophilia. Like hemophilia, VMD also has three subtypes. Hemophilia and VWD are mainly distinguished by the clotting factory affected.

When do bleeding disorders manifest?

Acquired bleeding disorders can also occur later in life due to medical conditions or lifestyle factors.

For example, liver disease can cause a decrease in clotting factors, leading to bleeding disorders. Heavy alcohol consumption can impair the liver’s ability to produce clotting factors, increasing the risk of bleeding.

What medications can cause bleeding disorders?

Certain medications, such as blood thinners or nonsteroidal anti-inflammatory drugs (NSAIDs), can also increase the risk of bleeding. These are:

Acetylated salicylates (aspirin)

• Bayer Aspirin
• Bufferin
• Ecotrin

Non-acetylated salicylates (diflunisal, salsalate)

• Disalcid
• Salsitab

Propionic acids (naproxen, ibuprofen)

• Advil
• Aleve
• Motrin

Acetic acids (diclofenac, indomethacin)

• Cataflam
• Voltaren

Enolic acids (meloxicam, piroxicam)

• Feldene
• Mobic

Anthranilic acids (meclofenamate, mefenamic acid)

• Ponstel

Naphthylalanine (nabumetone)

• Relafen

Selective COX-2 inhibitors (celecoxib, etoricoxib)

• Celebrex

How are bleeding disorders treated?

Treatment for bleeding disorders depends on the underlying cause and severity of the condition.

Treatment for genetic bleeding disorders

For genetic bleeding disorders such as hemophilia or VWD, treatment may involve replacement therapy with the missing clotting factor. This can be administered through intravenous (IV) infusions on a regular basis or as needed.

Other treatments may include medications to promote blood clotting, such as desmopressin or antifibrinolytics.

Treatment for acquired bleeding disorders

Treating acquired bleeding disorders may involve addressing the underlying medical condition or adjusting medications.

For example, individuals with liver disease may benefit from treatment to improve liver function, while those taking blood thinners may need to reduce their dosage or switch to a different medication.

Outlook

Living with a bleeding disorder can be challenging, but there are steps individuals can take to manage their condition and reduce their risk of bleeding.

This may include avoiding activities that increase the risk of injury, such as contact sports or heavy lifting.

It is also important to maintain good oral hygiene to reduce the risk of gum bleeding and to use caution when shaving or using sharp objects.

Bleeding disorders can have a significant impact on an individual’s quality of life, but with proper diagnosis and disease management, healthy and fulfilling lives are possible.

If you suspect you may have a bleeding disorder, it is important to speak with your healthcare provider to receive a proper diagnosis and develop an appropriate treatment plan.