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Bleeding and Clotting Disorders

Bleeding and Clotting: A Delicate Balance

Hemostasis is the body's system for controlling bleeding and clotting. Normally, a delicate balance exists. Too much clotting (thrombophilia) could cause dangerous blood clots to form, but not enough clotting could result in serious bleeding problems. The body has several mechanisms to maintain the right amount of bleeding and clotting. However, abnormalities in this control process can disrupt the balance and lead to excessive bleeding or clotting.

Throughout the course of a normal day, your blood vessels sustain many minor injuries of which you are not aware. When a blood vessel is damaged, your body triggers a cascade of clotting reactions that involve 3 major processes:

 

 

 

 

Blood clot formation is balanced by reactions that stop the clotting process. When enough fibrin has formed, Factor V is inactivated by Activated Protein C (APC). This way the clot does not become larger than necessary. As enzymes repair the damaged blood vessel, the clot is slowly dissolved.

Although the activation of this clotting process occurs normally, a problem may arise in a person with thrombophilia. This is because he or she may possess blood clotting proteins in abnormal amounts or may have proteins that do not function normally, leading to a tendency to excessive blood clotting. Likewise, a person who does not possess adequate amounts of clotting proteins could be more susceptible to bleeding when blood vessels are injured.

Most clotting and bleeding disorders can be managed with the help of blood products and medications that can decrease the formation of blood clots or help accelerate the clotting of blood to stop bleeding. Many times these disorders require patients to remain under the care of a health care provider with expertise in the diagnosis and treatment of these bleeding and clotting disorders.

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Last Reviewed: Aug 11, 2014

Elizabeth A Varga, MS, CGC
Clinical Assistant Professor of Pediatrics
College of Medicine
The Ohio State University