What Is a Mallory-Weiss Tear?

Medically Reviewed by Minesh Khatri, MD on February 20, 2024
4 min read

A Mallory-Weiss tear (also known as Mallory-Weiss syndrome) happens when part of your lower esophagus tears. The esophagus is an essential part of your digestive system. It’s made of tissue that forms a hollow tube and connects the back of your throat to your stomach, using rhythmic muscle contractions to transport your food.

Internal bleeding from Mallory-Weiss tears can cause many different and potentially serious health problems. Here is what you should know about Mallory-Weiss tears, the symptoms they cause, and how they can be diagnosed and treated.

Mallory-Weiss syndrome occurs when strong pressure in your abdomen tears the tissue in your lower esophagus. The most common cause of Mallory-Weiss tears is frequent or violent vomiting and coughing.

Some other possible Mallory-Weiss tear causes are:

  • Childbirth
  • Inflammation in your stomach lining or esophagus
  • Chronic hiccups
  • Chest or abdominal trauma
  • Heavy lifting
  • Chemotherapy
  • Hiatal hernia (when your stomach pushes up through muscles that separate your chest and abdomen)

Mallory-Weiss tears cause internal bleeding in your lower esophagus. These tears can have a variety of symptoms such as:

  • Chest or abdominal pain
  • Vomiting blood that is either bright red or dark-colored and looks like coffee grounds
  • Bloody stools
  • Stools that look black or tarry
  • Diarrhea
  • Pale skin
  • Feeling faint, weak, or dizzy
  • Feeling out of breath

Mallory-Weiss tears cause up to 15% of reported upper gastrointestinal bleeding, and many more people are likely to have mild tears that go undiagnosed. In mild cases, untreated Mallory-Weiss tears can cause anemia, extreme tiredness (fatigue), and shortness of breath. 

Some people with Mallory-Weiss syndrome might not feel any pain but still have severe internal bleeding. Untreated severe Mallory-Weiss syndrome can cause low blood pressure, a racing pulse, difficulty producing urine, and shock

If you are vomiting blood, passing bloody stools, or have any other symptoms of a Mallory-Weiss tear, it is important to call your doctor and get medical help as soon as possible. 

Doctors can diagnose Mallory-Weiss tears by asking you about your symptoms and doing some tests to check for the condition. 

Mallory-Weiss tears cause internal bleeding, so your doctor will usually check for signs of blood in your stool. They may also want to use an endoscope to look inside your esophagus for signs of tearing. The endoscope is a long tube that is inserted into your mouth and down your esophagus. It has a special camera attached that lets your doctor see any internal tears or bleeding.

Around 80% to 90% of Mallory-Weiss tears will heal on their own without any special medical treatment. 

If you have a Mallory-Weiss tear, your doctor might want you to take medication to help lower your stomach acid so that your body can heal more effectively. 

If your bleeding doesn’t stop on its own or is severe, your doctor might suggest a few different treatments depending on your condition. Some possible Mallory-Weiss tear treatment options are:

  • Sealing the tears. An endoscope (a long tube with an attached camera) lets doctors see and seal any tears you might have. Tears are sealed with cauterization methods that use heat or chemicals, or with electrical currents (electrocoagulation).
  • Applying direct pressure to the tears. Doctors use a special catheter with an inflatable balloon. After the catheter is inserted into your esophagus, the balloon is inflated. Pressure on the tears from the balloon helps stop the bleeding.
  • Repairing the tears surgically. Surgery is usually the last resort for Mallory-Weiss tears that will not stop bleeding. It is usually not performed unless other forms of less invasive treatment don’t work.

Depending on the severity of your Mallory-Weiss tear, you might need other treatments such as blood transfusions or medications to control your bleeding, blood pressure, and any pain you might feel.

Many people with Mallory-Weiss syndrome are adults between ages 50 and 60, but it can affect people of all ages, including children. 

Men are more than twice as likely to have a Mallory-Weiss tear than women. 

Drinking alcohol can increase your risk for vomiting, which in turn increases your chance of contracting Mallory-Weiss syndrome. An estimated 50% to 70% of people with Mallory-Weiss tears have a history of drinking excessive amounts of alcohol.

The most common causes of Mallory-Weiss tears are frequent and severe vomiting and coughing. You can lower your risk of Mallory-Weiss syndrome by limiting how much alcohol you drink, quitting smoking, and avoiding other things that might make you vomit or cough.