Prolonged bleeding from cuts – Causes, Diagnosis & Treatment

Causes:

• Medications: Anticoagulants (blood thinners) like warfarin or heparin, as well as some over-the-counter medications like aspirin or NSAIDs, can interfere with blood clotting and lead to prolonged bleeding.
• Platelet Disorders:
  • Thrombocytopenia: A low platelet count. Platelets are essential for blood clotting.
  • Idiopathic Thrombocytopenic Purpura (ITP): An autoimmune disorder that affects platelets.
  • Von Willebrand Disease: A genetic disorder that affects a protein involved in blood clotting.
• Clotting Factor Deficiencies: Hemophilia is a group of inherited bleeding disorders caused by deficiencies in specific clotting factors.
• Liver Disease: The liver produces many clotting factors, so severe liver disease can affect blood clotting.
• Vitamin K Deficiency: Vitamin K is essential for the production of some clotting factors.
• Connective Tissue Disorders: Some connective tissue disorders, such as Ehlers-Danlos syndrome, can affect blood vessel integrity and lead to prolonged bleeding.

Diagnosis:

• Medical History: Detailed information about bleeding episodes, including frequency, duration, and any other symptoms. Also, a review of medications, medical conditions, and family history of bleeding disorders.
• Physical Exam: A general physical exam, looking for signs of bleeding or bruising.
• Blood Tests:
  • Complete Blood Count (CBC): To check platelet levels.
  • Prothrombin Time (PT) and Partial Thromboplastin Time (PTT): Tests that measure how long it takes blood to clot.
  • Bleeding Time: Measures how long it takes for a small cut to stop bleeding.
  • Factor Assays: Specific blood tests to measure the levels of different clotting factors.
• Other Tests: Depending on the suspected cause, other tests may be necessary.

Treatment:

• Medication Adjustment: If medication is causing the prolonged bleeding, the doctor may adjust the dose or recommend an alternative.
• Platelet Transfusion: In cases of low platelet count or platelet dysfunction, platelet transfusions may be necessary.
• Clotting Factor Replacement: For clotting factor deficiencies like hemophilia, replacement therapy with the missing clotting factor is the main treatment.
• Vitamin K Supplementation: For vitamin K deficiency.
• Treatment of Underlying Condition: If the prolonged bleeding is due to an underlying medical condition, such as liver disease, treatment will be directed at that condition.
• Local Measures: For minor cuts, applying pressure to the wound is usually sufficient to stop bleeding. In some cases, sutures may be needed.

Important Considerations:

• Consult a healthcare professional for any prolonged or excessive bleeding, even from minor cuts. Do not delay seeking medical advice.
• If you are taking any blood-thinning medications, do not stop taking them without consulting your doctor.
• Early diagnosis and treatment are crucial for managing bleeding disorders and preventing complications.