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Rare Diseases 2023

SíMallory-Weiss syndrome: causes, symptoms and treatment

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SíMallory-Weiss syndrome: causes, symptoms and treatment
SíMallory-Weiss syndrome: causes, symptoms and treatment

Mallory-Weiss syndrome is a disease characterized by a sudden increase in pressure in the esophagus, which can happen due to frequent vomiting, severe coughing, constant retching or hiccups, resulting in abdominal or chest pain and vomiting with blood.

The treatment of the syndrome must be guided by the gastroenterologist or general practitioner according to the signs and symptoms presented by the person and the severity of the bleeding, being often necessary that the person stays in the hospital so that they receive the appropriate care and complications are avoided.

Causes of Mallory-Weiss Syndrome

Mallory-Weiss syndrome can occur as a consequence of any condition that increases pressure in the esophagus, the main causes of which are:

  • Bulimia nervosa;
  • Deep cough;
  • Constant hiccups;
  • Chronic alcoholism;
  • Strong blow to the chest or abdomen;
  • Gastritis;
  • Esophagitis;
  • Major physical exertion;
  • Gastroesophageal reflux.

In addition, Mallory-Weiss syndrome may also be related to hiatal hernia, which corresponds to a small structure that is formed when a portion of the stomach passes through a small hole, the hiatus, however more studies need to be carried out to confirm that hiatal hernia is also one of the causes of Mallory-Weiss syndrome. Learn more about hiatal hernia.

Main symptoms

The main symptoms of Mallory-Weiss syndrome are:

  • Bloody vomiting;
  • Very dark and foul-smelling stools;
  • Excessive fatigue;
  • Abdominal pain;
  • Nausea and dizziness.

These symptoms can also indicate other gastric problems, such as ulcers or gastritis, for example, so it is recommended to go to the emergency room for an endoscopy, diagnose the problem and start the appropriate treatment.

How is the treatment

Treatment for Mallory-Weiss syndrome should be guided by a gastroenterologist or general practitioner and is usually initiated while in hospital to stop bleeding and stabilize the patient's general condition. During hospitalization, it may be necessary to receive saline directly into the vein or have blood transfusions to compensate for blood loss and prevent the patient from going into shock.

So, after stabilizing the general condition, the doctor asks for an endoscopy to be performed to see if the esophageal lesion continues to bleed. Depending on the endoscopy result, treatment is appropriate as follows:

  • Bleeding lesion: the doctor uses a small device that runs down the endoscopy tube to close off damaged blood vessels and stop bleeding;
  • Lesion that does not bleed: the gastroenterologist prescribes antacids, such as omeprazole or cimetidine, to protect the wound site and facilitate healing.

Surgery for Mallory-Weiss syndrome is only used in the most severe cases, in which the doctor cannot stop the bleeding during endoscopy, requiring surgery to sew the lesion. After treatment, the doctor may schedule several appointments and other endoscopy tests to ensure that the lesion is healing properly.

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