by EBSCO Medical Review Board

Definition

Mallory Weiss syndrome is a tear. It forms in the lining where the stomach and esophagus meet. The esophagus is the tube that goes from your mouth to your stomach.

Sometimes the tears bleed. The blood may pass through the gastrointestinal (GI) tract. It can also be moved up and out of the body when vomiting.

Causes

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

  • Repeated vomiting
  • Intense coughing
  • Seizures
  • Childbirth
  • Direct injury to the GI tract

Risk Factors

The chances of Mallory Weiss tears are higher if you have problems that increase pressure in stomach such as:

Symptoms

Mallory Weiss tears may cause:

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

Sometimes, bleeding from the tears can happen rapidly and be serious. You may notice:

  • Feeling weak
  • Lightheadness or faintness
  • Breathing problems
  • Belly pain
  • Diarrhea
  • Pale skin

Bleeding that is light and happens over a long period of time may make you feel tired and cause breathing problems.

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.

You may have:

  • A physical exam
  • Blood tests
  • Stool tests
  • Upper GI endoscopy —a thin, lighted tube is placed in the mouth and moved into the stomach and upper part of the small intestine
  • A nasogastric tube placed through the nose and into the stomach
  • Angiography —to see the blood vessels

Treatment

Mallory Weiss tears will heal on their own.

If the tear is severe, you may need surgery to close the it. A transfusion can be used to replace lost blood.

Angiography

Angiography can also be used to control bleeding. Other tools are used to find the bleeding. Medicines or other materials are injected into the blood vessels to control it.

Endoscopy

Endoscopy can also be used to stop bleeding by:

  • 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 lower your chances of Mallory Weiss tears:

  • If you drink alcohol, do so in moderation. Moderation is 2 drinks a day or less for men and 1 drink a day or less for women.
  • Treat conditions that cause excessive coughing or vomiting

RESOURCES

American College of Gastroenterology  http://patients.gi.org 

National Institute of Diabetes and Digestive and Kidney Diseases  https://www.niddk.nih.gov 

CANADIAN RESOURCES

Canadian Association of Gastroenterology  https://www.cag-acg.org 

Canadian Digestive Health Foundation  http://www.cdhf.ca 

References

Acute upper nonvariceal gastrointestinal bleeding. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T905671/Acute-upper-nonvariceal-gastrointestinal-bleeding.

Gastrointestinal (GI) bleeding. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: https://www.niddk.nih.gov/health-information/digestive-diseases/gastrointestinal-bleeding.

Revision Information