Mallory-Weiss Syndrome – Causes, Symptoms and Treatments that we should not ignore. In addition, Mallory-Weiss syndrome refers to bleeding from mucosal tears (Mallory-Weiss tear) at the junction of the esophagus and stomach , typically resulting from straining coughing or vomiting.
It was first described by G. Kenneth Mallory and Soma Weiss, in 1929, in alcoholic patients. It is estimated to affect 4 in every 100,000 individuals, with a higher incidence in men than in women.
It is also common in patients who have eating disorders. In addition, there is evidence that indicates that the existence of hiatal hernia is a predisposing factor.
Clinically, blood is observed after an episode of vomiting (hematemesis) after several attempts to vomit or productive vomiting , but blood in the stool (melena) can also be observed, with no history of vomiting .
Causes of Mallory-Weiss Syndrome: The most common cause of MWS issevere or prolonged vomiting . While this type of vomiting can occur with stomach ailment , it also frequently occurs due to chronic alcohol abuse or bulimia.
Other conditions can result in an esophageal tear , too. These include:
- Trauma to the chest or abdomen;
- severe or prolonged hiccups;
- Intense cough ;
- Heavy lifting or straining;
- Gastritis , which is an inflammation of the stomach lining
- Hiatal hernia, which occurs when a part of your stomach pushes on a part of your diaphragm;
- Receiving cardiopulmonary resuscitation (CPR) can also lead to an esophageal tear ;
MWS is more common in men than in women. It occurs more often in people with alcoholism. According to the National Organization for Rare Disorders, people between the ages of 40 and 60 are more likely to develop this condition. However, there are cases of Mallory-Weiss tears in children and young adults.
Symptoms of Mallory-Weiss Syndrome: MWS does not always produce symptoms. This is more common in mild cases when esophageal tears produce only a small amount of bleeding and heal quickly without treatment.
In most cases, however, symptoms will develop. These may include:
- Abdominal pain;
- Vomiting blood, called hematemesis;
- involuntary vomiting ;
- Bloody or black stools;
Blood in vomit will usually be dark and clotted and may look like coffee sauce. Occasionally it may be red, which indicates that it is fresh. The blood that appears in your stool will turn dark and look like tar unless you have heavy bleeding, in which case it will be red. If you have these symptoms, seek immediate emergency care. In some cases, blood loss from MWS can be substantial and potentially fatal.
There are other health problems that can produce similar symptoms. Symptoms associated with MWS can also occur with the following disorders:
- Zollinger-Ellison syndrome, which is a rare disorder in which small tumors create excess stomach acids that lead to chronic ulcers;
- Chronic erosive gastritis, which is inflammation of the stomach lining that causes ulcer-like lesions.
- Esophageal perforation ;
- Peptic ulcer;
- Boerhaave syndrome, which is a rupture of the esophagus due to vomiting ;
Diagnosed with Mallory-Weiss Syndrome: Your doctor will ask you about any medical issues, including daily alcohol intake and recent illnesses, to identify the underlying cause of your symptoms.
If your symptoms indicate active bleeding in the esophagus , your doctor may do what’s called an esophagogastroduodenoscopy (EGD). You will need to take a sedative and pain reliever to avoid discomfort during this procedure.
Your doctor will insert a small, flexible tube with a camera attached, called an endoscope, down your esophagus and into your stomach. This can help your doctor see your esophagus and identify the tear’s location.
Your doctor will likely also order a complete blood count (CBC) to confirm your red blood cell count. Your red blood cell count may be low if you have bleeding in your esophagus . Your doctor will be able to determine if you have MWS based on the results of these tests.
Treatment for Mallory-Weiss Syndrome: According to the National Organization for Rare Disorders, bleeding that results from tears in the esophagus will stop on its own in about 80 to 90 percent of MWS cases. Healing usually takes a few days and does not require treatment. But if the bleeding doesn’t stop, you may need one of the following treatments.
You may need endoscopic therapy if the bleeding doesn’t stop on its own. The doctor performing the EGD may perform this therapy. Endoscopic options include:
- Injection therapy or sclerotherapy, which delivers medication to the tear to close the blood vessel and stop bleeding
- Coagulation therapy, which delivers heat to seal the torn vessel;
- Extensive blood loss may require the use of transfusions to replace lost blood;
Sometimes endoscopic therapy is not enough to stop the bleeding, so other ways to stop the bleeding must be used, such as laparoscopic surgery to cut the tear closed. If you cannot undergo surgery, your doctor may use arteriography to identify the bleeding vessel and connect it to stop the bleeding.
Prevention of Mallory-Weiss Syndrome: To prevent MWS, it is important to treat conditions that cause long episodes ofsevere vomiting . Excessive alcohol use and cirrhosis can trigger recurrent episodes of MWS. If you have MWS, avoid alcohol and talk to your doctor about ways to manage your condition to prevent future episodes.