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Mallory Weiss Syndrome

Definition

Mallory-Weiss Syndrome is a tear in the lining of the lower esophagus or upper stomach where they meet. The esophagus is a tube that connects your mouth and stomach.

When these tears bleed they can pass blood down into the digestive system or upwards with vomit. These tears will most often heal on their own but some may require additional care.

Causes    TOP

Mallory Weiss tears are caused by too much pressure in the abdomen. This can be caused by:

  • Prolonged vomiting
  • Intense coughing
  • Intense physical activities like seizures or childbirth
  • Direct trauma to the area

Risk Factors    TOP

Certain factors may increase your chance of Mallory Weiss tears. These include conditions that may induce intense vomiting or increased pressure in stomach such as:

Symptoms    TOP

If you have any of these symptoms, do not assume they are due to Mallory Weiss tears. Other things may cause these symptoms. Tell your doctor if you have:

  • Blood in vomit
  • Vomit that looks like coffee ground
  • Black, tarry stool
  • Blood in the stool

Sometimes, bleeding from the tears can occur suddenly and be severe. You may notice symptoms like:

  • Weakness
  • Lightheadness or faintness
  • Shortness of breath
  • Abdominal pain
  • Diarrhea
  • Paleness

Bleeding that is light and occurs over a long period of time may make you feel tired and short of breath.

Diagnosis    TOP

Your doctor will ask about your symptoms and medical history. You may also be asked if you noticed the blood after vomiting, retching or seizures. A physical exam will also be done.

To determine the location, cause, and amount of your bleeding your doctor may take a:

  • Complete blood count
  • Stool test—to check for blood in the stool
  • Upper GI endoscopy—a thin, lighted tube is inserted down the throat to examine the digestive tract and collect tissue samples
  • Nasogastric lavage—a tube placed through the nose and into the stomach removes contents to check for bleeding
  • Angiography—an x-ray of the blood vessels, that may also be used as treatment

Treatment    TOP

Mallory Weiss tears will often heal by themselves without treatment.

If the tear is severe your doctor may recommend further treatment. You may need surgery to close the tear or a blood transfusion for excessive blood loss.

Angiography

Angiography can control bleeding. The angiography will help locate the bleeding. The doctor will then inject medications or other materials into the blood vessels. These medications will control the bleeding until the tear can heal.

Endoscopy

Endoscopy can also be used to stop bleeding. An endoscope is a tube that is placed into the mouth and passed through the esophagus. Your doctor can stop the bleeding by several methods including:

  • Injecting chemicals into the bleeding site
  • Using a heat probe, electric current, or laser to seal off the bleeding site
  • Using a band or clip to close off blood vessels

Prevention    TOP

To help reduce your chance of Mallory Weiss tears:

  • Avoid excess alcohol use
  • Treat conditions that cause excessive coughing or vomiting

RESOURCES:

American College of Gastroenterology
http://gi.org
American Gastroenterological Association
http://www.gastro.org

CANADIAN RESOURCES:

References:

Acute upper nonvariceal gastrointestinal bleeding. EBSCO DynaMed Plus website. Available at: http://www.dynamed.... Updated January 14, 2016. Accessed September 30, 2016.
Bleeding in the digestive tract. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at:
...(Click grey area to select URL)
Accessed July 2012.
Last reviewed June 2016 by Daus Mahnke, MD
Last Updated: 6/20/2013

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