Mallory-Weiss Tear
What is Mallory Weiss Tear?
Mallory Weiss Tear refers to in the mucosa at junction of the stomach an esophagus (gastroesophageal junction).
Before getting into its detail, let us first know, what is esophagus?
Esophagus is a tube like structure that extends from your throat to the stomach. Its major function is to carry to food from your mouth all the way to your stomach.
In fancy words, Mallory Weiss Tear involves a superficial disruption in the esophagus, most commonly gastroesophageal junction.
Mallory Weiss Tear is relatively common cause of up to 15% of upper gastrointestinal bleeding.
The tear is often around 1 inch in length.
What are the predisposing factors of Mallory Weiss Tear?
- It is more likely to occur around the age of 40-60.
- Males are more prone to the tear as compared to women.
What are the risk factors associated with Mallory Weiss Tear?
- Gastroesophageal surgery
- Alcohol consumption
- Gastroesophageal reflux disease
- Hyperemesis gravidarium
- Bulimia nervosa
What causes Mallory Weiss Tear?
- The first and foremost cause of this tear is Iatrogenic. It can be caused by endoscopy, biopsy and esophageal dilation.
- Retching/Coughing/Vomiting can lead to a tear in esophagus.
- Ingestion of caustic/corrosive substances can corrode the mucosa of esophagus and result in a tear.
- Carcinoma
Other less common causes include childbirth or hiatal hernia that increase the pressure in abdominal region.
Shearing force likely from expulsion of gastric contents
How will I know if my esophagus has Mallory Weiss Tear?
It is usually asymptomatic as it is hard to tell if you are bleeding inside. However, following are some symptoms that you may notice in this condition:
- Hematemesis : It is most common symptom. There are multiple episodes of vomiting that initially have NO blood but then hematemesis occurs i.e. vomiting is blood stained.
- Blood tinged mucus
- Pain in chest or neck region
- Epigastric pain
- Melana or hematochezia : Stool is bright red in colour. It can be due to ingestion of blood. The ingested blood is when not digested travels to the large intestine and gets mixed with the stool.
- Dizziness/ syncope
- Paleness and shortness of breath
- Abdominal pain
How is Mallory Weiss Tear diagnosed?
If after examining your sputum and stool, your doctor gets suspicious of Mallory Weiss Tear, he will perform cetain investigations like:
- Endoscopy – To take a good look inside your esophagus by passing a camera down your mouth with the help of a flexible tube.
- Imaging to rule out boerhaave’s syndrome
- Lab tests : CBC
What is the treatment for Mallory Weiss Tear?
- The treatment for Mallory Weiss Tear is generally supportive as it is often self-limiting. The esophagus heals itself in some time without any need for external
- Proton-pump inhibitors are given to aid in the recovery of esophageal mucosa.
- Cauterization is an effective method to avoid any further damage and seal the area.
- Epinephrine injection
- Haemoclipping
- Band ligation
- Embolization
- Surgery