What is a  Bleeding Disorder?   

Bleeding disorders is a general term for  a wide range of medical problems that lead  to poor  blood clotting and continuous bleeding. Doctors also call them terms  such as coagulopathy, abnormal  bleeding and clotting disorders. 

When someone has a  bleeding disorder they have a  tendency to bleed longer. The disorders can result from defects in the  blood vessels or from abnormalities  in the blood itself. The abnormalities may be in blood clotting factors  or in platelets. 

Blood clotting,  or coagulation, is  the process that controls bleeding. It changes  blood from a liquid to a solid. It's  a complex process involving as many as 20 different plasma proteins, or  blood clotting factors. Normally, a complex chemical process occurs using these clotting factors  to form a substance  called fibrin that stops bleeding. When certain  coagulation factors are deficient or missing, the process doesn't occur normally. 

Within seconds of an injury, tiny cells  in the blood, called platelets, bunch  together around the wound. Blood proteins, platelets, calcium and other tissue factors react together and  form what's called  a clot, which acts like a  net over  the wound. Over  the next several days  to weeks,  the clot strengthens, then dissolves  when the wound  is healed.

In people with  bleeding disorders, clotting factors  are missing or don't work as  they should. This causes them to bleed for a  longer time than those whose blood factor levels are normal. It's  a myth that persons  with bleeding disorders bleed to death from minor injuries  or their blood flows faster.  Bleeding problems can  range from mild to severe. 

Symptoms include: 

• Excessive  bleeding
• Excessive bruising 
• Easy bleeding 
• Nose bleeds 
• Abnormal  menstrual bleeding 

Bleeding disorder risks include: 

• Scarring of  the joints or joint disease
• Vision loss from bleeding into the eye 
• Chronic anemia from blood loss. Anemia is a low red blood cell count 
• Neurologic or psychiatric problems 
• Death, which  may occur with large amounts  of blood loss  or bleeding in critical areas, such as the brain. 

Causes  
Some  bleeding disorders are present at birth  and are  caused by rare inherited disorders. Others are developed during certain illnesses (such as vitamin K deficiency, severe liver disease),  or treatments (such as use  of anticoagulant drugs  or prolonged use of antibiotics). They can include hemophilia  and other very rare blood disorders. There are many causes of bleeding disorders, including: 

• von Willebrand's disease , which  is an inherited blood disorder thought to affect between 1% and 2% of the population 
• Immune system-related diseases, such as allergic reactions to medications, or reactions to an infection 
• Cancer, such as leukemia, which is  a blood cancer 
• Liver disease 
• Bone marrow problems 
• Disseminated intravascular coagulation, which is a condition often associated with child bearing, cancer, or infection, in which the body's clotting system functions abnormally 
• Pregnancy-associated eclampsia, also known as severe toxicity of pregnancy 
• Antibodies, a type of immune system protein,  that destroy blood clotting factors 
• Medicines, such as aspirin, heparin, warfarin, and drugs used  to break up blood clots. 

Congenital  bleeding disorders are very rare,  and with  the exception of hemophilia  and von Willebrand disease, education about them has not been a priority of the medical community. Most have only been discovered  and described in the past few decades. 

Notes: DrJMinor

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EditText of this page (last edited December 23, 2009)