Mallory-Weiss Tear

What is a Mallory-Weiss tear?

Your esophagus is the tube that carries food from your throat to your stomach. It plays a vital role in digestion. Sometimes, violent coughing or vomiting can tear the tissue of your lower esophagus and it can start to bleed. The condition is called a Mallory-Weiss tear.

What causes a Mallory-Weiss tear?

A Mallory-Weiss tear is most often caused by violent coughing or vomiting. Less common causes are a hiatal hernia or childbirth, which can increase pressure in your abdomen. Drinking alcohol can make vomiting and a tear more likely.

What are the symptoms of a Mallory-Weiss tear?

It can be hard to tell that you have a Mallory-Weiss tear and that you are bleeding inside. But you may have some of these symptoms:

  • Vomit that is bright red or that looks like coffee grounds

  • Black or tar-like stools

  • Stools with blood in them

  • Weakness, dizziness, faintness

  • Shortness of breath

  • Diarrhea

  • Paleness

  • Abdominal or chest pain that sometimes goes to your back

How is a Mallory-Weiss tear diagnosed?

If you have symptoms of a Mallory-Weiss tear, your healthcare provider may check your stool for blood. Your healthcare provider may also do an endoscopy. For this test, a flexible tube is put in through your mouth and down into your esophagus. A camera at the end of the tube lets the healthcare provider see the tear inside your esophagus.

How is a Mallory-Weiss tear treated?

A Mallory-Weiss tear will stop bleeding and begin to heal on its own in most cases. Sometimes you will need treatment. If treatment is needed, an endoscope may be used to give you an injection or a heat treatment to stop the bleeding. Or it may be used to insert a clip that closes the tear and stops the bleeding. Often, your healthcare provider will also prescribe medicines to lower stomach acid and help with healing. If you are on blood thinning medicine, check with your healthcare provider about when you should stop and restart the blood thinner.

What are possible complications of a Mallory-Weiss tear?

In rare cases, a Mallory-Weiss tear leads to severe internal bleeding. You get a rapid pulse, a drop in blood pressure, trouble producing urine, and shock. If mild bleeding goes untreated, it may result in anemia with fatigue and shortness of breath.

Can a Mallory-Weiss tear be prevented?

There isn’t a lot you can do to prevent a Mallory-Weiss tear. Staying away from situations that cause violent vomiting, such as drinking too much alcohol, or coughing, such as smoking, can help lessen your risk.

When should I call my healthcare provider?

Blood in your vomit or stool is a serious symptom that calls for urgent medical help. If you notice any of the symptoms of a Mallory-Weiss tear, call your healthcare provider right away.

Key points about a Mallory-Weiss tear

  • A Mallory-Weiss tear is a tear of the tissue of your lower esophagus.

  • It is most often caused by violent coughing or vomiting.

  • A Mallory-Weiss tear can be diagnosed and treated during an endoscopic procedure.

  • If the tear is not treated, it can lead to anemia, fatigue, shortness of breath, and even shock.

Next steps

Tips to help you get the most from a visit to your health care provider:

  • Know the reason for your visit and what you want to happen.

  • Before your visit, write down questions you want answered.

  • Bring someone with you to help you ask questions and remember what your provider tells you.

  • At the visit, write down the name of a new diagnosis and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.

  • Know why a new medicine or treatment is prescribed and how it will help you. Also know what the side effects are.

  • Ask if your condition can be treated in other ways.

  • Know why a test or procedure is recommended and what the results could mean.

  • Know what to expect if you do not take the medicine or have the test or procedure.

  • If you have a follow-up appointment, write down the date, time, and purpose for that visit.

  • Know how you can contact your provider if you have questions.

Online Medical Reviewer: Jen Lehrer MD
Online Medical Reviewer: Stacey Wojcik MBA BSN RN
Online Medical Reviewer: Tennille Dozier RN BSN RDMS
Date Last Reviewed: 8/1/2023
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