What is a Mallory-Weiss tear?

A Mallory-Weiss tear is a tear of the tissue of your lower esophagus. This tear can start to bleed. Your esophagus is the tube that carries food from your throat to your stomach. It plays a vital role in digestion.

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 symptoms, including:

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

• Black or tar-like stools.

• Stools with blood in them.

• Weakness, dizziness, or faintness.

• Shortness of breath.

• Diarrhea.

• Paleness.

• Belly 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 doctor may check your stool for blood. Your doctor 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 your doctor 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 doctor will also prescribe medicines to lower stomach acid and help with healing. If you are on blood thinning medicine, check with your doctor 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. To help lower your risk, stay away from things that can cause violent vomiting, such as drinking too much alcohol. Also stay away from things that can cause severe coughing, such as smoking.

When to contact your doctor

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, contact your doctor 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 doctor:

• 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 doctor 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 doctor 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 doctor if you have questions.