Is Mallory-Weiss Syndrome?
Severe and prolonged vomiting can result in tears in the lining
of the esophagus. The esophagus is the tube that connects your throat to your
stomach. Mallory-Weiss syndrome (MWS) is a condition marked by a tear in the
mucous membrane, or inner lining, where the esophagus meets the stomach. Most
tears heal within 7 to 10 days without treatment, but Mallory-Weiss tears can
cause significant bleeding. Depending on the severity of the tear, surgery may
be necessary to repair the damage.
Causes Mallory-Weiss Syndrome?
The most common cause of MWS is severe or prolonged vomiting.
While this type of vomiting occurs with illness, it also frequently occurs due
to chronic alcohol abuse or bulimia.
Although frequent vomiting typically causes MWS, there are other
conditions that can result in a tear of the esophagus. These include:
- trauma to the chest or abdomen
- severe or prolonged hiccups
- intense coughing
- heavy lifting or straining
- gastritis, which is an inflammation of the
lining of the stomach
- a hiatal hernia, which occurs when part of your stomach
pushes through part of your diaphragm
Receiving cardiopulmonary resuscitation (CPR) can also lead to a
tear of the esophagus.
MWS is more common in males than females. It occurs more often in
people with alcoholism. According to the National
Organization for Rare Disorders, people between the ages of 40 and 60 are
more likely to develop this condition. However, there are cases of
Mallory-Weiss tears in children and young adults.
Are the Symptoms of Mallory-Weiss Syndrome?
MWS doesn’t always produce symptoms. This is more common in mild
cases when tears of the esophagus produce only a small amount of bleeding and
heal quickly without treatment.
In most cases, however, symptoms will develop. These may include:
- abdominal pain
- severe vomiting
- vomiting up blood, which is called hematemesis
- involuntary retching
- bloody or black stools
Blood in the vomit will usually be dark and clotted, but
occasionally it can be red, which indicates it’s fresh. It will look like
coffee grounds. Blood that appears in the stool will be dark and look like tar.
If you have these symptoms, seek immediate emergency care. In some cases, blood
loss from MWS is substantial and can be life-threatening.
There are other health problems that may produce similar
symptoms. Only your doctor can determine if you have MWS.
Symptoms associated with MWS may also occur with the following
- Zollinger-Ellison syndrome, which is a rare
disorder in which small tumors create excess stomach acids that lead to chronic
- chronic erosive gastritis, which is an inflammation
of the stomach lining that causes ulcer-like lesions
- perforation of the esophagus
- a peptic ulcer
- Boerhaave’s syndrome, which is a rupture of the
esophagus due to vomiting
Is Mallory-Weiss Syndrome Diagnosed?
Your doctor will ask you about any medical issues, including
daily alcohol intake and recent illnesses, to identify the underlying cause of
If your symptoms indicate active bleeding in the esophagus, your
doctor may do what is called an esophagogastroduodenoscopy (EGD). You’ll need
to take a sedative and a painkiller to prevent any discomfort during this
procedure. Your doctor will insert a small, flexible tube with a camera
attached to it, called an endoscope, down the esophagus and into the stomach.
This can help your doctor see your esophagus and identify the location of the
Your doctor will likely also order a complete blood count (CBC) to
confirm the number of red blood cells. Your red blood cell count may be low if
you have bleeding in the esophagus. Your doctor will be able to determine if
you have MWS based on the findings from these tests.
Is Mallory-Weiss Syndrome Treated?
According to the National
Organization for Rare Disorders, the bleeding that results from tears in
the esophagus will stop on its own in about 80 to 90 percent of MWS cases. This
typically occurs in a few days and doesn’t require treatment.
You may need surgery if the bleeding doesn’t stop on its own.
Surgical options include the following:
- Injection therapy, or sclerotherapy, delivers
medication to the tear to close off the blood vessel and stop the bleeding.
- Coagulation therapy delivers heat to the torn
vessel, sealing it off.
- Arteriography identifies the bleeding vessel and
plugs it to stop the bleeding.
Extensive blood loss may require the use of transfusions to
replace lost blood.
Medications to reduce stomach acid production, such as famotidine
(Pepcid) or lansoprazole (Prevacid) may also be necessary. However, the effectiveness
of these medications is still under debate.
How Can I Prevent Mallory-Weiss Syndrome?
Recurrent bleeding may result if you have liver problems including
cirrhosis, or scarring of the liver. If you have a blood disorder such as
hemophilia that prevents your blood from clotting normally, you also may have
It’s important to treat conditions that cause long episodes of
severe vomiting to prevent MWS. Excessive alcohol use and cirrhosis can trigger
recurring episodes of MWS. Avoid alcohol and talk to your doctor about ways to
manage your condition to prevent future episodes.