Bleeding disorders are conditions that cause individuals to bleed too much. This bleeding can occur with injury or following invasive procedures like surgery, or it can occur spontaneously. There are a variety of bleeding disorders, including but not limited to:
- Hemophilia A (factor VIII deficiency)
- Hemophilia B (factor IX deficiency)
- von Willebrand disease
- Platelet disorders
These uncommon conditions can occur when someone has low clotting factors, low von Willebrand protein or platelets that do not work correctly. These factors, proteins and platelets work together to help us stop bleeding. Any change to these elements can lead to increased bleeding.
Hemophilia A and B are usually inherited conditions caused by a mutation in the gene that instructs the body in making clotting factors. However, some individuals can also have a bleeding disorder without a family history of bleeding. Up to a third of cases of hemophilia are due to new mutations.
Individuals with von Willebrand disease have a deficiency or absence of von Willebrand protein, which supports the activity of factor VIII in the body. Platelets help play a role in forming a clot at the time of injury or surgery.
Symptoms
The issue with bleeding disorders is that the individual bleeds longer, not necessarily heavier. Secondly, the bleeding can happen internally (into a joint or muscle) as well as externally (heavy periods). Everyone bleeds at times, such as with menstruation, trauma or surgery, but the challenge is knowing when the bleeding is abnormal or too much.
Symptoms of bleeding disorders can include:
- Frequent, severe nosebleeds – nosebleeds lasting longer than 15 minutes are abnormal
- Blood in poop or pee – blood in these areas is abnormal for anyone
- Prolonged bleeding in the gums and mouth following brushing or dental procedures
- Heavy menstrual periods – saturating a pad or tampon in two hours or less
- Getting large bruises (hematomas) due to bleeding in soft tissues and muscles, or frequent bruising on your skin
- Abnormally excessive bleeding after an injury or a surgical procedure
- Joint swelling when bleeding occurs in a joint area, such as knees, ankles or elbows. More serious cases can include bleeding into or around the brain or other internal organs.
Diagnosis
Your provider will get details of your medical history, symptoms, health conditions and family history. Your provider may conduct a physical exam to check for signs of a bleeding disorder, and blood tests will be performed to check for clotting factor, von Willebrand or platelet deficiencies.
Treatment
If you are confirmed to have a bleeding disorder, your treatment may involve replacing or adding the specific clotting factor or component that is missing or deficient. If there is an identified platelet disorder, other treatment options are available. New and advanced treatments have demonstrated significant improvement in the quality of life and long-term outcomes in patients living with a bleeding disorder.
UofL Health Can Help
If you feel you may have a bleeding disorder, see your primary care provider or contact the UofL Physicians – Hemophilia Treatment Center at 502-210-4301. The Hemophilia Treatment Center provides leading-edge and compassionate care to patients with bleeding disorders, including hemophilia, von Willebrand disease, platelet disorders and other rare clotting conditions.
Most of the bleeding disorders are chronic lifelong conditions and our care providers are committed to building enduring relationships, guiding patients through every step of care, including coordinating with other medical and surgical specialties when and if necessary. By partnering with each patient and their family, our center encourages and supports effective treatment to ensure the best possible outcomes.
