Health Library

Mallory Weiss Syndrome

Definition

Mallory Weiss syndrome is a tear in the lining of the food pipe (esophagus). The esophagus is the tube that goes from the mouth to the stomach.

Sometimes the tears bleed. If the bleeding continues, it can lead to anemia. Severe bleeding can be life-threatening.

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

Things that raise the risk of Mallory Weiss tears are:

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 happens fast and be serious. Signs may be:

  • Feeling weak
  • Lightheadedness or faintness
  • Breathing problems
  • Belly pain
  • Loose stools (poop)
  • Pale skin

Bleeding can also be light and happen over a long period of time. It can cause tiredness and breathing problems.

Diagnosis

The doctor will ask about symptoms and past health. This includes questions about bleeding after vomiting, retching, or seizures.

Tests may include:

  • 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 tube placed through the nose and into the stomach
  • Angiography —to see the blood vessels

Treatment

Mallory Weiss tears will heal on their own. Medicines may be given to reduce stomach acid. This can help the tissue heal faster.

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

Endoscopy can 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

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.

Prevention

To help lower the risk of Mallory Weiss tears:

  • Limit alcohol to no more than:
  • 2 drinks a day or less for men
  • 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 website. Available at: https://www.dynamed.com/approach-to/acute-nonvariceal-upper-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.

Mallory-Weiss tear. EBSCO DynaMed website. Available at:https://www.dynamed.com/condition/mallory-weiss-tear.

Samuel R, Bilal M, et al. Evaluation and management of non-variceal upper gastrointestinal bleeding. Dis Mon. 2018 ;64(7):333-343.