HYDERABAD : Thousands of people were concerned about bleeding disorders as Sadhguru, a renowned spiritual leader recently underwent surgery after suffering from brain bleeding. This incident alerted millions of people, including some of his followers, to learn more about the condition. Also, since March is observed as Bleeding Disorders Awareness Month, we approached experts to clarify our doubts about bleeding disorders.
Dr Shivanand Reddy, Sr Consultant Neurosurgeon at CARE Hospitals explained, “The body regulates blood clotting differently in bleeding disorders, where clotting may be insufficient, leading to excessive bleeding after surgery or injury. Parallelly, excessive clotting can cause thrombotic diseases and other health issues. Clotting factors, also called coagulation factors, along with platelets, work together to form blood clots. Any condition affecting the quantity or function of platelets or clotting components can lead to a bleeding disorder. Bleeding disorders are of two types: acquired, which develop during one’s lifetime, and inherited, present since birth.”
Causes
Describing the underlying causes, Dr Shivanand Reddy said that when a person bleeds, the body typically pools blood cells together to form a clot to stop the bleeding. Clotting factors are proteins in the blood that work with cells known as platelets to form clots. Haemophilia occurs when a clotting factor is missing or levels of the clotting factor are low. He further mentioned different types of haemophilia: congenital, acquired and haemophilia inheritance.
Complications of haemophilia can range from deep internal bleeding, causing limb swelling and potential nerve compression, leading to numbness or pain, to bleeding into critical areas like the throat or neck, compromising breathing. Joints may suffer damage due to recurrent internal bleeding, potentially resulting in arthritis or joint destruction, if left untreated. Individuals with severe haemophilia face rare but serious risks, like brain bleeding from minor head trauma and presenting symptoms such as persistent headaches, vomiting, lethargy, visual disturbances, weakness, or seizures.
Symptoms
Highlighting symptoms of a bleeding disorder, Dr Reddy specified that the type of bleeding disorder and its underlying cause significantly determine the symptoms exhibited. These symptoms can manifest shortly after birth or remain unnoticed until later stages of life. The range of symptoms associated with bleeding disorders varies, spanning from minor occurrences like sporadic nosebleeds to severe events such as haemorrhagic strokes. Interestingly, individuals with mild bleeding disorders may not display any symptoms until they experience an injury or undergo surgery.
The signs and symptoms of bleeding disorders include the presence of blood in urine or stool, and persistent and uncontrollable bleeding that may commence spontaneously or follow trauma, dental procedures, or surgical interventions. Other indications include frequent and sizable bruises, pronounced postpartum bleeding, and heavy menstrual periods extending beyond seven days. Additionally, bleeding disorders may present as petechiae, characterised by small spots beneath the skin, and discomfort or swelling due to bleeding into muscles or joints, a feature commonly observed in inherited haemophilia. Furthermore, prolonged bleeding from the umbilical stump, beyond the typical duration of one to two weeks after birth, may indicate a bleeding disorder.
Treatment
When asked about treatment options for bleeding disorders, Dr Padmavathi Kapila, Chief Consultant Obstetrician & Gynaecologist at Renova Hospitals said, “Individuals with haemophilia often require clotting factor replacement therapy to prevent excessive bleeding. This may involve regular infusions of clotting factor concentrates or recombinant factors. Those with mild haemophilia or Von Willebrand disease can benefit from desmopressin, a medication that stimulates the release of Von Willebrand factor and factor VIII from the body’s stores. Additionally, antifibrinolytic agents like tranexamic acid or aminocaproic acid can help prevent the breakdown of blood clots and reduce bleeding in certain situations. Platelet transfusions may be necessary for individuals with platelet disorders to improve clotting ability. In severe cases or emergencies, surgical interventions such as joint replacement or surgery to control bleeding may be necessary.”
Lifestyle changes
Furthermore, Dr Kapila added that implementing lifestyle changes is crucial for managing bleeding disorders. Regular, low-impact exercise preserves joint health, while a balanced diet with adequate vitamin K supports clotting function. Prioritise dental care, take safety precautions to prevent injuries and seek emotional support to cope with the challenges of living with a bleeding disorder.