About gastroesophageal laceration-hemorrhage
What is gastroesophageal laceration-hemorrhage?
Mallory-Weiss syndrome refers to a tear or laceration of the mucous membrane, most commonly at the point where the esophagus and the stomach meet (gastroesophageal junction). Such a tear may result in severe bleeding from the gastrointestinal tract. The immediate cause of the lesion is usually a protracted period of vomiting.
What are the symptoms for gastroesophageal laceration-hemorrhage?
MWS doesn’t always produce symptoms. This is more common in mild cases when tears of the esophagus 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 up blood, which is called hematemesis
- involuntary Retching
- bloody or stools
Blood in the vomit will usually be dark and clotted and may look like coffee grounds. Occasionally it can be red, which indicates it’s fresh.
Blood that appears in the stool will be dark and look like tar, unless you have a large bleed, 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 life threatening.
There are other health problems that may produce similar symptoms.
Symptoms associated with MWS may 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
- perforation of the esophagus
- peptic ulcer
- Boerhaave’s syndrome, which is a rupture of the esophagus due to Vomiting
It’s worth noting that MWS is a rare condition, and can only be diagnosed by a doctor. If you exhibit symptoms it’s important to see your physician immediately in order to get a proper diagnosis.
What are the causes for gastroesophageal laceration-hemorrhage?
The most common cause of MWS is severe or prolonged vomiting. While this type of vomiting can occur with stomach illness, it also frequently occurs due to chronic alcohol use or bulimia.
Other conditions can result in a tear of the esophagus as well. These include:
- trauma to the chest or abdomen
- severe or prolonged hiccups
- intense coughing
- heavy lifting or straining
- gastritis, which is an inflammation of the lining of the stomach
- hiatal hernia, which occurs when part of your stomach pushes through part of your diaphragm
Receiving cardiopulmonary resuscitation (CPR) can also lead to a tear of the esophagus.
MWS is more common in males than in females. 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.
What are the treatments for gastroesophageal laceration-hemorrhage?
According to the National Organization for Rare Disorders, the bleeding that results from tears in the esophagus will stop on its own in about 80 to 90 percent of MWS cases.
Healing typically occurs in a few days and doesn’t 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 can do this therapy. Endoscopic options include:
- injection therapy, or sclerotherapy, which delivers medication to the tear to close off the blood vessel and stop the bleeding
- coagulation therapy, which delivers heat to seal off the torn vessel
Extensive blood loss may require the use of transfusions to replace lost blood.
Surgical and other options
Sometimes, endoscopic therapy isn’t enough to stop the bleeding. So doctors use other ways of stopping it, such as laparoscopic surgery to sew the tear.
If you can’t undergo surgery, your doctor may use arteriography to identify the bleeding vessel and plug it to stop the bleeding.
Medications to reduce stomach acid production, such as famotidine (Pepcid) or lansoprazole (Prevacid), may also be necessary. However, the effectiveness of these medications is still under debate.
What are the risk factors for gastroesophageal laceration-hemorrhage?
- overusage of nonsteroidal anti-inflammatory drugs
- alcohol consumption
Is there a cure/medications for gastroesophageal laceration-hemorrhage?
An esophageal laceration is also referred to as the Mallory-Weiss syndrome/gastroesophageal laceration-hemorrhage. It highlights a laceration or tear of the mucous membrane. This commonly occurs at the point where the stomach and esophagus meet, also known as the gastroesophageal junction. This tear is likely to trigger extensive bleeding from the gastrointestinal tract.
- In most cases, it is evident that bleeding stops within 73 hours once a patient encounters an esophageal laceration. In order to heal the stomach and esophagus tear, healthcare practitioners are likely to prescribe medications to decrease stomach acid.
The most effective acid reducers are:
1. Proton pump inhibitors
2. H2-receptor blockers
- The healthcare experts will track the symptoms to affirm that the patient is healing effectively.
- The physicians may also inject epinephrine or vasopressin into the bleeding blood vessel. This happens during angiography to restrict bleeding.
Endoscopic options involve:
- Sclerotherapy or injection therapy: This delivers medication to the laceration site to restrict the bleeding from the blood vessel.
- Coagulation therapy: This delivers heat to seal the torn blood vessel to stop the bleeding.
- Patients who lose an extensive amount of blood are subjected to blood transfusion.
- Surgery is rarely required for an esophageal laceration.
- The medications usually prescribed to decrease stomach acid productions are famotidine or lansoprazole.
Trauma to chest or abdomen,Intense coughing,Prolonged hiccups, Hiatal hernia,Convulsions,Gastritis,Straining,CPR
Abdominal pain,Involuntary retching,Vomiting,Black or bloody stools