Mallory-Weiss Syndrome Definition, Reason, Symptoms, Treatment & Prevention
Definition
Mallory-Weiss syndrome is a condition characterized by a tear in the lining of the esophagus. The esophagus is the tube that connects the throat to the stomach.
Mallory-Weiss syndrome begins with episodes of severe and prolonged vomiting that causes a tear in the lining of the esophagus. Most tears heal in 7 to 10 days without treatment.
However, a Mallory-Weiss tear can cause heavy bleeding. Depending on the severity, surgical treatment may be needed to repair the damage.
Mallory-Weiss Syndrome Symptoms
Mallory-Weiss syndrome does not always cause symptoms. This often occurs in mild cases when the esophageal tear causes a small amount of bleeding that improves on its own without treatment.
However, in most cases, signs and symptoms may include:
- Abdominal pain
- Vomiting blood
- Black or bloody stools
Blood found in vomit is generally black and clotted, resembling coffee grounds. Sometimes, blood can also be red, which indicates that the blood is fresh blood. Blood that appears in the stool is generally black like tar, except for major bleeding when the blood is still red.
Someone who experiences these symptoms is advised to immediately see a doctor. In some cases, the blood loss in Mallory-Weiss syndrome can be significant enough to be life-threatening.
There are many other health problems that cause similar symptoms. Symptoms associated with Mallory-Weiss syndrome may also occur in the following disorders:
- Zollinger-Ellison syndrome is a rare disease in the form of small tumors, which cause excess stomach acid and then lead to the formation of chronic stomach ulcers.
- Chronic erosive gastritis, which is an inflammation of the stomach lining that can cause stomach ulcers.
- Esophageal tear.
- Peptic ulcer.
- Boerhaave’s syndrome, which is characterized by a tear in the esophagus from vomit.
Mallory-Weiss Syndrome Reason
The most common cause of Mallory-Weiss syndrome is severe and prolonged vomiting. Severe vomiting may occur with gastric disease. But it can also occur as a result of excessive alcohol use or the disorder of bulimia nervosa.
Several other conditions that can also cause tears in the esophagus are:
- Injury to the chest or abdomen
- Severe and prolonged hiccups
- Heavy and long cough
- Lifting heavy objects or straining
- Gastritis, which is inflammation of the lining of the stomach
- Hiatal hernia, a condition when part of the stomach is pushed through part of the diaphragm
- seizures
Mallory-Weiss syndrome is more common in men than women. In addition, this condition often occurs in those who have a habit of consuming alcohol.
According to the National Organization for Rare Disorders, this condition generally occurs in people aged 40 to 60 years. However, in a minority of cases, a Mallory-Weiss tear can also occur in children and young adults.
Diagnosis
The diagnosis of Mallory-Weiss syndrome is generally determined based on the results of a medical interview, physical examination, and certain investigations. The doctor can ask about the history of the health problems that are experienced, including daily alcohol intake, and other complaints that occur to identify the problems that cause complaints.
If the signs and symptoms experienced indicate the possibility of active bleeding in the esophagus, the doctor can perform an examination called an esophagogastroduodenoscopy (EGD). This examination uses a small, flexible tube with a camera, known as an endoscope, down the esophagus to the stomach. This step can help the doctor get an overview of the esophagus and identify the location of the tear.
The doctor may also order routine blood tests to confirm the red blood cell count. The red blood cell count is generally lower when there is esophageal bleeding. The doctor can determine whether Mallory-Weiss syndrome is present or not based on the findings of the various supporting examinations.
Mallory-Weiss Syndrome Treatment
According to the National Organization for Rare Disorders, bleeding that occurs as a result of a tear in the esophagus generally stops on its own in 80 to 90 percent of cases of Mallory-Weiss syndrome. Healing generally occurs within a few days and does not require specific treatment.
However, if the bleeding does not stop by itself, several treatment options that can be done are:
-
therapy endoscopic
Endoscopic therapy is needed if the bleeding does not stop on its own. Doctors who do EGD can do this therapy. This step includes injection therapy or sclerotherapy by delivering medicine to the tear to close the blood vessel and stop the bleeding.
It can also be accompanied by coagulation therapy, which delivers hot air to close torn blood vessels. If there is significant blood loss, the patient will need a transfusion to replace the lost blood.
-
Surgery and other actions
Sometimes, endoscopic therapy is not enough to stop bleeding. So, one way to stop bleeding that can be done is with laparoscopic surgery which aims to close the tear.
In patients who cannot be operated on, doctors can use arteriography to identify blood vessels that are bleeding and stop the bleeding.
-
Treatment
Medication can be given to reduce stomach acid production. However, the effectiveness of this treatment still needs to be evaluated further.
Prevention
To prevent Mallory-Weiss syndrome, it’s important to treat conditions that can trigger long-term vomiting early. Excessive alcohol consumption and cirrhosis of the liver can trigger repeated episodes of Mallory-Weiss syndrome.
Patients with this syndrome are advised to avoid alcohol consumption and discuss with a doctor. They must understand how to manage the condition so that recurring episodes can be prevented.