Increased bleeding tendency, also called hemorrhagic diathesis, can have several causes. In addition to treating the cause of the bleeding tendency, precautions help keep affected individuals safe.
What is increased bleeding diathesis?
If an affected person has an increased bleeding tendency, it manifests as bleeding that lasts too long and/or bleeding that is too severe compared with the injury sustained. In addition, an increased bleeding tendency can lead to spontaneous bleeding for which no external cause is apparent. Typical symptoms of an increased bleeding tendency include the frequent occurrence of hematomas (bruises) for no apparent reason. In addition, depending on the clinical picture, a person affected may have skin bleeding of various degrees:
If there is extensive bleeding, this is also referred to in medicine as suffusion. If, on the other hand, there are many small skin hemorrhages, this is known as purpura; visually, this phenomenon can easily be mistaken for a rash. While a very strong increased bleeding tendency is comparatively rare in the population, weak forms are more widespread.
Causes
An increased bleeding tendency can have various causes. First to be mentioned in this context is the presence of coagulation disorders. If such a clotting disorder is present, the so-called clotting factors are restricted or completely absent in an affected person. Since human coagulation factors are produced in the liver, almost every serious liver dysfunction is associated with a coagulation disorder. The comparatively rare hemophilia is also a coagulation disorder. Last but not least, an increased bleeding tendency in the context of coagulation disorders can be caused by blood-thinning medications. Frequently, an increased bleeding tendency is also caused by a deficiency of red blood cells. This can be caused, for example, by autoimmune reactions or (like the coagulation disorders) by certain drug administration. Finally, unstable/brittle blood vessels (e.g., due to disease or the natural aging process) can also result in an increased bleeding tendency.
Symptoms, complaints, and signs
In most cases, an ordinary life can be led without complications despite this condition. However, affected individuals must protect their bodies from various injuries and hazards, as even very minor injuries can cause severe bleeding. The bleeding cannot be stopped easily and does not stop on its own, so medical intervention is always necessary. In the worst case, the affected person can die from the disease if he loses too much blood. In this case, patients often suffer from bleeding gums or nosebleeds, which significantly reduces the quality of life of the affected person. Especially during surgical procedures or other medical interventions, the respective physician must be forewarned about the disease in order to avoid complications and other discomforts. Patients often suffer from low blood pressure and, in some cases, dizziness. It can also cause them to lose consciousness and injure themselves by falling. Furthermore, the disease has a negative effect on the patient’s ability to cope with stress, so that they often appear tired and groggy. In some cases, the severe bleeding tendency also leads to psychological discomfort or depression.
Diagnosis and course
Depending on the suspected cause of an increased bleeding tendency, a physician has various diagnostic tools at his or her disposal. For example, if it is to be tested whether vascular damage underlies the increased bleeding tendency, this can be done with the help of a blood pressure cuff on the arm. If a slightly inflated cuff leads to pinhead-sized spots on the skin after a few minutes, this indicates that the blood vessels are fragile. Blood coagulation disorders and/or red blood cell dysfunction can be diagnosed with the aid of special blood tests. The course of an increased bleeding tendency depends on the corresponding causes; if the causes can be treated or disappear on their own, the bleeding tendency may also subside.Hemophilia, for example, is not curable; symptoms can be limited by taking appropriate precautions by affected individuals.
Complications
Various complications can occur with an increased bleeding tendency, as the affected person’s blood may clot very slowly or not at all. For example, affected individuals suffer more nosebleeds. Even small injuries inside the nose can lead to severe bleeding. If such bleeding cannot be stopped at all, this complication can be counteracted with the help of permanent cooling. Gum bleeding is also not uncommonly excessive. Under certain circumstances, the gums can also become inflamed if the affected area becomes infested with bacteria or other contaminants. In the worst case, pus fluid may form and collect in an abscess. If such a clinical picture is present, a doctor should be consulted immediately. Otherwise, there is a risk of blood poisoning, which can even be fatal. With an increased tendency to bleed, bruising naturally occurs much more quickly. Even very minor concussions or little pressure can cause a hematoma to form. Of course, a “bruise” is not really a complication that needs to be investigated by a doctor. However, complications can arise during the healing process. If the blood collects under the skin, a negative pressure is created. For quick and effective treatment, a doctor should be consulted immediately.
When should you see a doctor?
A doctor should be consulted as soon as bleeding cannot be stopped by your own means. If a wound bleeds proportionally for a particularly long time or intensely, there is reason for concern. A doctor should be consulted if symptoms such as dizziness, conspicuous pallor or general weakness develop. If the affected person can no longer walk under his own power or suffers from an immense loss of strength, he requires medical treatment. If spontaneous bleeding occurs repeatedly, it should be clarified by a medical professional. Bruises that occur for no apparent reason or with mild concussions should be investigated. If they spread over the body or remain for several weeks, they should be presented to a physician. Unusual nosebleeds that occur for no reason and are prolonged should be discussed with a physician. If the affected person suffers from increased bleeding from the gums, care should also be taken. A medical examination is necessary, as germs can enter the organism through the open areas, which can lead to further diseases or inflammations. If pus forms, fever sets in or there is a loss of consciousness, a visit to the doctor is necessary. In the case of loss of consciousness, there is already an immense loss of blood. A doctor must therefore be consulted as soon as possible or an emergency doctor must be called.
Treatment and therapy
Just as the course of an increased bleeding tendency, an individual therapy is initially dependent on the underlying causes. Not in every case does a bleeding tendency require treatment; for example, some mild forms caused by platelet impairment often heal on their own. If the cause of a bleeding tendency can be clearly identified and if it is both treatable and in need of treatment, the first therapeutic goal is to combat the cause; if the increased bleeding tendency is due to an autoimmune disease, for example, the first step is to treat the underlying disease. If, on the other hand, drugs are responsible for an increased bleeding tendency, it is sometimes possible to replace them with similar preparations. Treatment of hemophilia primarily involves behavioral measures that should largely avoid injuries or risky operations. In the case of a very strong bleeding tendency or, for example, in the run-up to planned operations, platelets can, for example, be replaced or supplemented by special platelet concentrates, depending on the cause. Various clotting factors can also be supplied to the organism of an affected person by genetically engineered preparations.
Outlook and prognosis
Predicting an accurate outlook and prognosis for an increased bleeding tendency is very difficult, as this clinical picture can occur in varying degrees of severity. Affected individuals bleed profusely from even the smallest injuries.The coagulation of the blood is defective in such cases, so that without medical treatment there can be a large loss of blood. Bruises and bumps also cause hematomas much more quickly, so that internal bleeding can occur under certain circumstances. If such a blood clotting disorder remains without any treatment, then in the worst case death by bleeding to death is imminent. However, if the affected person decides to seek medical and drug treatment, then an existing blood clotting disorder can be corrected. However, for a positive prognosis, it is important to find the cause of this increased bleeding tendency. Only by eliminating the cause, can a positive prognosis be envisaged. Those who finally decide to undergo such treatment can expect a complete and smooth recovery.
Prevention
It is difficult to prevent the development of an increased bleeding tendency per se. If, on the other hand, a bleeding tendency is already known, various precautionary measures can protect against risky situations (for example, skill training to prevent falls or avoidance of risky sports). Finally, for various forms of increased bleeding tendency, clotting factors or other medications can be injected/administered as a preventive measure.
Follow-up care
An increased bleeding tendency often requires follow-up care. However, this looks different depending on the cause of the increased bleeding tendency. For example, a persistent nosebleed may be due to a variety of causes that require different treatment. In many cases where there is an increased bleeding tendency, no medical follow-up is needed. In the presence of hemophilia, follow-up is different than in the presence of a dilated blood vessel in the nose or the use of a blood-thinning medication such as Marcumar. As an inherited clotting disorder, hemophilia requires lifelong follow-up. However, sclerotherapy of a persistent bleeding vessel in the nose does not. The bleeding nose that bleeds because of taking Marcumar does require care as a deliberately produced clotting disorder. But follow-up care is probably not needed if the bleeding is successfully stopped. However, the Marcumar prescription is always monitored. It is for medically necessary initiated blood thinning after thrombosis or stroke. In the case of a hemorrhagic diathesis, preventive care always takes precedence over follow-up care. However, if leukemia exists, indicated by an increased bleeding tendency and hematomas, follow-up after the actual treatment is inevitable. In most cases, however, when there is an increased bleeding tendency, there are only slight hematomas, for example in the skin of aging people. This does not require follow-up care unless it is cosmetic.
What you can do yourself
If there is an increased tendency to bleed, eliminating the causes is a priority. In other cases, an individualized therapy must be devised. This can be supported by a number of self-help measures. For example, blood clotting can be regulated by dietary measures (e.g. dietary supplements with protein, zinc and vitamins) or a change in lifestyle. A conscious lifestyle helps those affected to reduce the risk of acute bleeding. On the one hand, this includes avoiding risky situations and dangerous sports. On the other hand, the risk of injury can be reduced by targeted dexterity and balance training. More generally, regular exercise also helps. Other measures that regulate blood flow also help with an increased bleeding tendency. However, the main focus of therapy is the causal treatment of the blood clotting disorder. Often a certain medication is responsible for the disorder, which can be discontinued in consultation with the physician. Or there is a hereditary disease such as hemophilia, which must be diagnosed and treated with the help of preventive measures. Last but not least, people with an increased bleeding tendency should always carry an emergency identification card. If an accident or fall then occurs, targeted treatment is possible.
