What is Mallory Weiss Syndrome?

Mallory Weiss syndrome (MWS)

is a condition which is caused by the laceration and associated bleeding in the junction of the esophagus and the stomach. The bleeding is usually from tears in the mucous lining of the stomach and esophagus. The laceration is caused by severe retching, coughing or vomiting.
80% of the incidences are seen in men and the average age of its occurrence is 60. In patients, who suffer from bleeding in the upper gastrointestinal tract, MWS is responsible for 5 % of such occurrences.

Gastrointestinal Bleeding

Causes of Mallory Weiss Tear

  • Alcoholism associated with vomiting and retching and related abrasion in the mucous lining of the stomach and esophagus.
  • Severe morning sickness in pregnancy associated with retching and vomiting.
  • Non Steroidal Anti Inflammatory Drugs (NSAIDs) are also known to cause tears and gastrointestinal bleeding.
  • Infection and inflammation of liver can cause vomiting and associated tears in the gastrointestinal cavity causing bleeding.
  • Eating Disorders like anorexia nervosa and bulimia nervosa are associated with voluntary vomiting. Forceful vomiting can cause retching on the surface of the stomach and esophageal wall.

Symptoms of upper gastrointestinal bleeding

  • Hematemesis or vomiting of blood after violent retching is often a symptom. Bleeding from the esophagus is generally manifested through blood vomit.
  • Melena or black tarry stools indicative of blood in feces.
  • Pallor or Paleness is a common symptom due to blood loss.
  • Anemia is also known to occur.
  • Frequent hiccups.
  • Changes in pulse rate and blood pressure depending on the degree of gastrointestinal bleeding.

Treatment for Mallory Weiss Tears

  • The tears heal on their own usually within 48 hours and the bleeding stops.
  • If alcoholism or eating disorders are the underlying reasons then recurrent vomiting and retching can worsen the tears. It is important to treat alcoholism and eating disorders prior to treating the tears and the bleeding.
  • Bleeding is sometimes stopped using epinephrine injections.
  • Vascular occlusion or intentional blockage of blood vessels in the area of the tears is also done in cases of severe bleeding. This is also known as embolization and is very rarely needed to treat the tears.
  • Ligation or tying of bleeding blood vessels is also an option.

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