Do you also bleed a lot from a small wound? Let's talk about von Willebrand Disease

Have you ever had a small cut that you couldn't stop bleeding for a long time? Or do you get big blue bruises even after a little bit of a bump? Sometimes we think these are normal things, but they could be a sign of a small problem with our blood. Today, we're going to talk about a less talked about but very common condition that affects blood clotting. That's von Willebrand disease.

Simply put, what is von Willebrand disease (VWD)?

von Willebrand disease (VWD) is a condition that occurs when our blood clotting process does not work properly. It is more of an inherited weakness in our body than a disease.

Imagine, when we have a cut in one of our blood vessels, a small type of cell (platelets) in our body comes to stop the bleeding and seals the wound. It's like filling a hole in a wall with bricks. These platelets stick together and have a special "gum"-like protein in our blood that helps them form a strong clot. That's what we call von Willebrand factor (VWF) .

A person with VWD may not have enough of this VWF protein in their body, or the protein they have may not work properly. Then, because the blood clot does not form properly, it takes a long time to stop bleeding even from a small injury.

What are the main types of VWD?

This condition is mainly divided into three types. There is also a type that is not congenital but develops later.

What are the symptoms of this condition?

Symptoms vary depending on the type of VWD you have.

Mild and moderate symptoms of types 1 and 2

• Even a small injury can cause a big blue bruise: Do you notice that your body is turning blue in places?
• Frequent nosebleeds: Some people have frequent nosebleeds, and they are difficult to stop.
• Excessive bleeding after surgery or tooth extraction: Doesn't the bleeding stop for hours after a tooth is extracted?
• Women experience heavy bleeding during their periods: Is the bleeding so heavy that you have to change your pad at least once an hour? Does it come with clots? Over time, this can lead to iron deficiency anemia .
• Blood in the stool or urine.

Severe symptoms of type 3

In this type, all of the above symptoms can be severe. In addition,

• Sudden, severe bleeding for no reason.
• Blood leaks into the joints and soft tissues, causing swelling and severe pain.

How do you recognize this?

Your doctor will first ask about your symptoms and family medical history. Because this is a hereditary condition, it is important to find out if anyone else in your family has had this type of bleeding problem.

Then, they will do some special tests to see how long it takes for your blood to clot and how well it does. Mainly,

• Measuring the amount of VWF protein in the blood (Antigen test).
• Testing the function of that protein.

Sometimes, things like stress and exercise can change VWF levels, so you may need to have these tests done more than once to get the most accurate results.

What are the treatments? How to manage?

Although VWD cannot be cured, it can be controlled and managed to lead a normal life. The most important thing is to reduce the risk of bleeding.

1. Avoiding certain medications

You should avoid taking certain medications that thin the blood. Your doctor will often tell you not to take aspirin and NSAIDs (such as ibuprofen and naproxen). Acetaminophen is a safer option for pain or fever. But be sure to ask your doctor before taking any medication.

2. Specific treatments

Treatment depends on the severity and type of your symptoms.

• Desmopressin Acetate (DDAVP): This is the most commonly used treatment. It can be given as a nasal spray or as an injection. It works by stimulating the release of the VWF protein stored in our cells into the blood. This medication can cause water retention in the body, so your doctor may recommend that you limit your fluid intake.
• Clotting Factor Concentrates: A concentrate containing the VWF protein given intravenously (IV). This is usually used in severe cases and before surgery.
• Other medications: In cases such as tooth extraction, pills or liquid medications such as aminocaproic acid or tranexamic acid may be given to stop the blood clot from dissolving.
• Special treatments for women: For women with heavy periods, birth control pills can increase VWF levels. There are also methods such as wearing a hormone-containing loop (levonorgestrel intrauterine device) or removing the lining of the uterus (endometrial ablation).

Finally, if you have a severe condition like Type 3, if you experience bleeding, it is an emergency. You should go to a hospital's Emergency Department (ETU) immediately. Delay can be life-threatening.

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