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Bleeding disorders

Show Alternative Names
Coagulopathy

Bleeding disorders are a group of conditions in which there is a problem with the body's blood clotting process. These disorders can lead to heavy and prolonged bleeding after an injury or surgery. Bleeding can also begin on its own and may be difficult to stop.

Specific bleeding disorders include:

Causes

Blood clotting - Animation

This animation depicts the process of blood clotting in an enlarged view of a small artery. Cells shown include red blood cells, platelets, fibrin, and clotting factors.

Normal blood clotting involves blood particles, called platelets, and as many as 20 different plasma proteins that layer over the platelets. These proteins are known as blood clotting or coagulation factors. These factors interact with other chemicals to form a substance called fibrin that stops bleeding.

Problems can occur when platelets are low in number or do not work properly or when certain coagulation factors are low or missing. Bleeding problems can range from mild to severe.

Some bleeding disorders are present at birth and are passed down through families (inherited). Others develop from:

  • Illnesses, such as vitamin K deficiency or severe liver disease
  • Treatments, such as the use of drugs to stop blood clots (anticoagulants) or the long-term use of antibiotics

Bleeding disorders can also result from a problem with the number or function of platelets. These disorders can also be either inherited or develop later (acquired). The side effects of certain drugs often lead to the acquired forms.

Symptoms

Symptoms may include any of the following:

  • Bleeding into joints or muscles
  • Bruising easily
  • Heavy bleeding
  • Heavy menstrual bleeding
  • Nosebleeds that do not stop easily
  • Excessive bleeding with surgical procedures
  • Umbilical cord bleeding after birth

The problems that occur depend on the specific bleeding disorder, and how severe it is.

Exams and Tests

Tests that may be done include:

Treatment

Treatment depends on the type of disorder. It may include:

  • Clotting factor replacement
  • Fresh frozen plasma transfusion
  • Platelet transfusion
  • Other treatments

Support Groups

More information and support for people with bleeding disorders and their families can be found at:

Outlook (Prognosis)

Outcome also depends on the disorder. Most primary bleeding disorders can be managed. When the disorder is due to diseases, such as DIC, the outcome will depend on how well the underlying disease can be treated.

Possible Complications

Complications may include:

  • Bleeding in the brain
  • Severe bleeding (usually from the gastrointestinal tract or injuries)

Other complications can occur, depending on the disorder.

When to Contact a Medical Professional

Contact your health care provider if you notice any unusual or severe bleeding.

Prevention

Prevention depends on the specific disorder.

Review Date: 2/2/2023

Reviewed By

Mark Levin, MD, Hematologist and Oncologist, Monsey, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

References

Gailani D, Benjamin TF, Wheeler AP. Rare coagulation factor deficiencies. In: Hoffman R, Benz EJ, Silberstein LE, et al, eds. Hematology: Basic Principles and Practice. 8th ed. Philadelphia, PA: Elsevier; 2023:chap 135.

Hall JE, Hall ME. Hemostasis and blood coagulation. In: Hall JE, Hall ME, eds. Guyton and Hall Textbook of Medical Physiology. 14th ed. Philadelphia, PA: Elsevier; 2021:chap 37.

Neff AT. Von Willebrand disease and hemorrhagic abnormalities of platelet and vascular function. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 164.

Disclaimer

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. No warranty of any kind, either expressed or implied, is made as to the accuracy, reliability, timeliness, or correctness of any translations made by a third-party service of the information provided herein into any other language. © 1997- A.D.A.M., a business unit of Ebix, Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

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Blood clotting - Animation

Ouch!

Here's how platelets form clots. This small artery has a cut. Blood flowing past the cut includes red blood cells that carry oxygen, platelets that come from white blood cell fragments, and clotting factors that help blood clot. When a blood vessel is damaged, blood cells and plasma ooze into surrounding tissue. Platelets immediately stick to the edges of the cut and release chemicals that attract more platelets. Eventually, a platelet plug is formed, and the outside bleeding stops.

On the inside, clotting factors cause a cascade of activity that includes strands of blood-borne material called fibrin sticking together to seal the inside of the wound. Eventually, the blood vessel heals, and several days later, the blood clot dissolves.

 

Blood clotting - Animation

Ouch!

Here's how platelets form clots. This small artery has a cut. Blood flowing past the cut includes red blood cells that carry oxygen, platelets that come from white blood cell fragments, and clotting factors that help blood clot. When a blood vessel is damaged, blood cells and plasma ooze into surrounding tissue. Platelets immediately stick to the edges of the cut and release chemicals that attract more platelets. Eventually, a platelet plug is formed, and the outside bleeding stops.

On the inside, clotting factors cause a cascade of activity that includes strands of blood-borne material called fibrin sticking together to seal the inside of the wound. Eventually, the blood vessel heals, and several days later, the blood clot dissolves.

 
 
 
 

 

 
 

 
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