• Mallory Weiss Syndrome

    Definition

    Mallory Weiss Syndrome is a tear in the lining of the esophagus. The esophagus is a tube that connects your mouth and stomach.
    The tears most often happen near the stomach. When these tears bleed they can pass blood into the digestive system or through vomit. These tears will most often heal on their own but some may require additional care.

    Causes

    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

    Risk Factors

    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:
    • Gastrointestinal illness
    • Alcoholism
    • Seizure disorder

    Symptoms

    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
    • Dizziness 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

    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 and cause of your bleeding your doctor may take a:
    • Blood test—to determine amount of blood loss
    • Stool test—to check for blood in the stool
    • 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

    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 medicines or other materials into the blood vessels. These medicines 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

    To help reduce your chance of Mallory Weiss tears take these steps:
    • Avoid excess alcohol use
    • Treat conditions that cause excessive coughing or vomiting

    RESOURCES

    The American College of Gastroenterology http://www.acg.gi.org/

    American Gastroenterological Association http://www.gastro.org/

    CANADIAN RESOURCES

    HealthLink BC http://www.healthlinkbc.ca/

    C-Health http://chealth.canoe.ca/

    References

    Acute upper gastrointestinal bleeding. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/. Updated May 19, 2011. Accessed July 13, 2012.

    Bleeding in the digestive tract. National Digestive Diseases Information Clearinghouse website. Available at: http://digestive.niddk.nih.gov/ddiseases/pubs/bleeding/index.aspx. Accessed July 2012.

    Mallory-Weiss Syndrome. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/. Updated May 28, 2010. Accessed July 13, 2012.

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