From the Research
The five most common symptoms of Mallory-Weiss syndrome are hematemesis, melena, epigastric or upper abdominal pain, nausea, and lightheadedness or dizziness, as reported in the most recent study 1. These symptoms are a result of a longitudinal tear in the mucosa at the gastroesophageal junction, typically caused by forceful vomiting, retching, or coughing that increases abdominal pressure against a closed glottis.
- Hematemesis is the hallmark symptom, occurring in approximately 85% of cases, and presents as bright red blood or coffee-ground-like material in vomit.
- Melena develops as blood passes through the digestive tract and is present in about 45% of patients.
- Epigastric pain often precedes the bleeding episode and may be associated with the forceful vomiting or retching that causes the mucosal tear.
- Nausea commonly accompanies the condition due to the underlying cause that triggered the vomiting.
- Lightheadedness or dizziness results from blood loss, particularly in severe cases. Most cases (80-90%) stop bleeding spontaneously, but patients should seek immediate medical attention when these symptoms appear to prevent potential complications from blood loss, as emphasized in the study 1. The diagnosis can be suspected from the history and confirmed by upper gastrointestinal endoscopy, which is the prime method of diagnosis, as stated in the study 2. Endoscopic treatment for hemostasis, such as band ligation, may be necessary for patients with active bleeding or signs of recent bleeding at endoscopy, as recommended in the study 1. The use of proton pump inhibitors and antiemetics seems logical in all cases, although their efficacy is not demonstrated in the literature, as noted in the study 1.