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Mallory-Weiss Syndrome

Medically reviewed by Last updated on Aug 31, 2022.

What is Mallory-Weiss syndrome?

Mallory-Weiss syndrome is a tear in the tissue where your esophagus and stomach meet. The tear causes bleeding that may be mild or severe. Anything that causes forceful vomiting or retching can cause a tear. Movements that cause straining, or an injury to your abdomen can also cause a tear.

What are the signs and symptoms of Mallory-Weiss syndrome?

  • Blood in your vomit or bowel movements
  • Material that looks like coffee grounds in your vomit
  • Dark, tarry bowel movements
  • Pain in your upper abdomen or your back
  • Shortness of breath
  • Feeling weak, dizzy, or faint
  • Pale skin

What increases my risk for Mallory-Weiss syndrome?

You are at a higher risk if you are a man. Mallory-Weiss syndrome can happen at any age, but it is most common between 40 to 60 years. The following can also increase your risk:

  • Large amounts of alcohol, or severe liver disease
  • Coughing, hiccups, or straining to have a bowel movement
  • Seizures, a hiatal hernia, or esophagitis or gastritis (inflammation in your esophagus or stomach)
  • An injury to your abdomen
  • Bulimia (binge eating and then purging by vomiting)
  • In women, giving birth, or hyperemesis gravidarum (severe nausea and vomiting during pregnancy)
  • Use of aspirin or NSAID medicine

How is Mallory-Weiss syndrome diagnosed?

Your healthcare provider will examine you and ask about your symptoms. Tell your provider if you recently had severe vomiting or an injury to your abdomen. Tell your provider if you had blood in your vomit or bowel movement, and when you first saw the blood. You may also need any of the following:

  • Endoscopy is a procedure used to examine your esophagus. An endoscope is a long, flexible tube with a light on the end. Your healthcare provider will guide the tube down your throat to the tear.
  • Blood tests are used to check the number of red blood cells (RBCs). A low number of RBCs may mean you have anemia from the blood loss. Blood tests will also show how well your blood clots.
  • A bowel movement sample may be checked for blood.

How is Mallory-Weiss syndrome treated?

Your healthcare provider may stop or change some of your medicines. Bleeding from a Mallory-Weiss tear usually stops on its own within 48 hours. Treatment is not needed unless the tear is severe or bleeding does not stop:

  • Endoscopy may be used to stop the bleeding. Your healthcare provider may place clips or bands to hold the tear closed so it can heal. Your provider may instead inject medicine or use an electric current to stop the bleeding.
  • Medicines may be given to lower the amount of acid your stomach makes. You may also be given medicine to control vomiting and nausea.
  • Fluids may be given through an IV if you lose a large amount of blood or become dehydrated.
  • A blood transfusion may be needed if you lose a large amount of blood.
  • Surgery may be needed to repair the tear if other treatments do not work.

What can I do to manage or prevent Mallory-Weiss syndrome?

  • Rest as needed. Rest will help your body heal. Your healthcare provider may recommend bedrest to prevent movement that can cause or worsen a tear.
  • Talk to your healthcare provider about all of your medicines. Do not take aspirin or NSAID medicines. These medicines can cause stomach bleeding. They can also thin your blood and keep your blood from clotting normally. Talk to your healthcare provider about any prescription anticoagulant (blood thinning) medicines you take.
  • Drink more liquids as directed. Liquids help prevent dehydration. You may need to replace body fluid you lost from vomiting or blood loss. Ask your healthcare provider how much liquid to drink each day and which liquids are best for you.
  • Limit or do not drink alcohol as directed. Alcohol increases your risk for a Mallory-Weiss tear. Alcohol use over a long period can cause liver damage. Liver damage also increases your risk for a tear. Ask your healthcare provider if alcohol is safe for you to drink. If you are going to drink alcohol, do not drink large amounts at one time. Limit alcohol to 2 drinks a day if you are a man or 1 drink a day if you are a woman. A drink of alcohol is 12 ounces of beer, 5 ounces of wine, or 1½ ounces of liquor.
  • Ask your healthcare provider if you should eat soft foods while you heal. Examples of soft foods include applesauce, yogurt, and oatmeal. Do not eat foods that may scratch or irritate your esophagus or stomach. Some examples are crackers, nuts, spicy foods, and citrus fruits such as oranges.

When should I seek immediate care?

  • You are confused or less alert than usual.
  • Your heartbeat or breathing is faster than usual.
  • You are lightheaded, dizzy, or faint.
  • You are sweating and your skin is pale.
  • Your lips or fingernails are blue.
  • You are urinating little or not at all.

When should I call my doctor?

  • You have questions or concerns about your condition or care.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your healthcare providers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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