Mallory Weiss Syndrome

Mallory Weiss syndrome refers to bleeding from tears in the lining of the tube that carries food from the mouth to the stomach (esophagus). The tears occur at the entrance to your stomach. Usually the bleeding stops by itself after 24–48 hours. In some cases, surgery may be needed.

What are the causes?

This condition may be caused by severe or long-lasting vomiting or coughing.

What increases the risk?

You are more likely to develop this condition if:

• You abuse or drink too much alcohol.
• You have certain eating disorders, such as eating a lot of food at once and then vomiting to prevent weight gain (bulimia).

What are the signs or symptoms?

Symptoms of this condition include:

• Vomiting bright red or black, coffee-ground-like material.
• Abdominal pain.
• Having black, tarry stools.
• Fainting or experiencing loss of consciousness.

How is this diagnosed?

This condition is diagnosed with an esophagogastroduodenoscopy (EGD). During an EGD procedure, a flexible tube (endoscope) is put into your mouth, passed through your esophagus into your stomach, and then into your small bowel. An EGD will show your health care provider where the tear is.

How is this treated?

Treatment for this condition depends on the severity of the tear or bleeding. It is necessary to stop any bleeding as soon as possible. Treatment includes:

• Medicines to treat nausea.
• Medicines to help the lining of your esophagus heal.
• Having endoscopy to treat an area of bleeding with high heat (coagulation), injections, or surgical clips.
• Receiving donated blood (transfusion) to replace lost blood. This is done in cases of severe bleeding.
• Having a procedure that involves first doing an angiogram and then blocking blood flow to the bleeding site (embolization).
• Having other surgical procedures if initial treatments do not control bleeding.

In some cases, it may be necessary to treat any conditions that may have caused the tear in the esophagus. This includes: 

• Treating long-lasting or recurrent vomiting or coughing.
• Getting help for alcoholism or an eating disorder.

Follow these instructions at home:

• Take over-the-counter and prescription medicines only as told by your health care provider.
• You may be told to stop taking aspirin or ibuprofen as these, and other medicines like them, can cause bleeding.
• Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.
• Do not use any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. If you need help quitting, ask your health care provider.
• Follow instructions from your health care provider about eating or drinking restrictions.
• Do not drink alcohol.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if you:

• Have nausea or vomiting.
• Have abdominal pain.
• Have unexplained weight loss.
• Need help to stop smoking or drinking alcohol.

Get help right away if you:

• Have dizziness that does not go away, or you are light-headed or faint.
• Start vomiting again, or you have vomit that is bright red or looks like black coffee grounds.
• Have bloody, black, or tarry stools.
• Have chest pain.
• Cannot eat or drink.

Summary

• Mallory–Weiss syndrome refers to bleeding from tears in the lining of the tube that carries food from the mouth to the stomach (esophagus).
• Risk factors include severe or long-lasting coughing or vomiting, and heavy alcohol use.
• Take over-the-counter and prescription medicines only as told by your health care provider. You may have to avoid certain medicines that cause bleeding.