Vomiting of blood can cause a Mallory-Weiss Syndrome in context, which may develop due to long-term irritation of the esophagus. It often affects alcoholics and people with bulimia.
What is Mallory-Weiss Syndrome?
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Of a Mallory-Weiss Syndrome is the medicine when longitudinal tears in the esophagus cause bleeding with vomiting of blood (hematemesis).This clinical picture can develop after a sudden increase in pressure in the lower part of the esophagus, for example through vomiting, choking or coughing.
In the worst case, the esophagus can even tear (Boerhaave syndrome). In Mallory-Weiss syndrome, however, the esophageal wall does not tear completely and the contents of the esophagus do not get into the chest cavity. It occurs predominantly in people in whom the lining of the esophagus is chronically irritated for various reasons.
causes
The main cause of Mallory-Weiss syndrome is chronic damage to the mucous membrane, often associated with a sudden increase in pressure in the esophagus. This leads to elongated tears in the mucous membrane that can bleed profusely. In those affected, the mucous membrane of the esophagus was usually irritated over a long period of time, for example through regular alcohol consumption or frequent vomiting, as is the case with bulimia.
Gagging, vomiting or coughing can cause the pressure in the esophagus to rise so much that the mucous membrane tears and causes bleeding. More rarely, the cause is seizures or lifting heavy loads. People with reflux disease, in which the mucous membrane is chronically irritated by the reflux of acidic chyme into the esophagus, are also at higher risk. If the mucous membrane is already damaged, it will not be able to withstand a sudden increase in pressure and it can tear more easily.
Symptoms, ailments & signs
A typical symptom that occurs in Mallory-Weiss syndrome is vomiting of blood after vomiting without blood several times. Those affected are usually already bothered by the nausea and the frequent vomiting and with Mallory-Weiss syndrome there is also the fear that is triggered by vomiting blood. The vomiting blood can be so severe that it weakens the circulation.
There is then a drop in blood pressure and a reflex-induced increase in heart activity. In addition to vomiting blood, blood appears in the stool, which is pitch black in color due to decomposition in the intestines. Because of the anemia, the body becomes generally weak. Many sufferers also suffer from stomach pains due to frequent vomiting.
Diagnosis & course of disease
In order to be able to make an exact diagnosis, the patient's medical history is first asked about his complaints and symptoms. In order to be able to assess exactly whether it is Mallory-Weiss syndrome, a gastroscopy is performed, which also examines the condition of the esophageal mucosa. If the patient states that he had to choke before the bleeding occurred, this is an indication of Mallory-Weiss syndrome.
During the mirroring of the upper gastrointestinal tract, an inserted endoscope is used to examine the esophagus, stomach and duodenum for possible injuries or pathological changes. If sources of bleeding are found during the examination, they can be treated immediately. If the bleeding is left untreated for a long time, it can lead to acute circulatory failure.
In the case of a complete rupture of the esophagus (Boerhaave syndrome), there is also the risk that fluid will accumulate in the pleural space (pleural effusion) or that air will collect in the middle space between the two pectoral sacs in the lungs. This area also includes the esophagus, heart and large blood vessels such as the aorta and vena cava.
Complications
Due to the Mallory-Weiss syndrome, those affected suffer in many cases from vomiting, which can also contain blood. It is not uncommon for vomiting blood to lead to a panic attack or sweating. This also leads to a weakening of the circulation so that the patient can lose consciousness in the further course.
This can lead to injuries if you fall. Likewise, blood pressure drops and the heart has to beat faster to keep blood flowing. It can also lead to heart failure. It is not uncommon for the Mallory-Weiss syndrome to lead to bloody stools and thus also to anemia.
In addition to vomiting, stomach pain is relatively common, leading to significant restrictions in everyday life and a reduction in quality of life. Without treatment it can lead to circulatory failure and thus to death of the patient. A blood transfusion is usually needed to treat Mallory-Weiss syndrome. There are no particular complications.
However, treatment of the underlying disease is also necessary, so that those affected often have to undergo a psychological examination or withdrawal. Whether this leads to a reduction in life expectancy depends to a large extent on the underlying disease.
When should you go to the doctor?
People who consume alcohol daily for several years or who show withdrawal symptoms as soon as they do not consume alcohol need a doctor. You belong to the risk group of Mallory-Weiss syndrome and should be examined. A visit to the doctor is also advisable for people whose BMI is below the recommended values. If self-initiated vomiting occurs over several weeks or months immediately after the intake of food, a doctor should be consulted. An eating disorder poses another risk for the condition. Basically, a doctor is needed when the circulation is weakened.
A low performance level, a drop in blood pressure or an increase in heart rate should be examined and clarified by a doctor. Vomiting blood is cause for concern. A doctor should be consulted as soon as possible as immediate action is required if this symptom occurs. If blood appears in the stool, a doctor's visit is also required. The leakage of blood indicates an existing irregularity in the organism, in which there should be no further delays. Stomach pain, black faeces, repeated vomiting, an internal weakness or nausea are indications of an existing illness. Various medical tests are required so that a diagnosis can be made and a treatment plan can be drawn up.
Treatment & Therapy
The therapy is very much dependent on the location and nature of the crack, the time and the general condition of the patient and is therefore individually adapted. If there is massive blood loss, the patient's circulatory system must first be strengthened with intravenous blood transfusions and fluid transfusions. Flushing with fluid can stop the bleeding; if not, the endoscope is used to inject adrenaline in a circle around the bleeding source at a distance of about 0.5 centimeters.
In addition, the source of bleeding, often an artery, can be obliterated endoscopically. If this measure does not help either, surgery is necessary. In addition, there is a drug therapy with mucous membrane-protecting and acid-inhibiting drugs, so that the mucous membrane is not further irritated. To achieve a good chance of recovery, an early operation is important.
If it occurs more than 24 hours after the tear, there is a risk that the patient will die from serious complications. The chances of recovery depend very much on the patient's lifestyle after the operation. If the cause is excessive alcohol consumption, the patient must in future refrain from excessive alcohol and stick to the medication. In the case of causative reflux disease, regular check-ups must be carried out in order to prevent Mallory-Weiss syndrome.
You can find your medication here
➔ Medicines against vomiting and nauseaOutlook & forecast
The prognosis for Mallory-Weiss syndrome is linked to the underlying disease. In most cases, there is an addiction or a chronic illness that is causing the symptoms. Therefore, this syndrome is primarily a consequence of an existing impairment and less an independent disease. In many cases, there is an alcohol abuse or an eating disorder. Both of these lead to severe vomiting and thus to irritation of the esophagus.
As soon as the primary disease is successfully treated, the symptoms of the esophagus regress in most cases. If the disease progresses unfavorably, the tissue damage is irreversible. Chronic pain develops. Without medical care, therefore, an increase in health irregularities can be expected. If the person concerned changes their way of life and accepts treatment, the administration of medication can significantly alleviate the symptoms.
In rare cases, surgery is performed. Although this is associated with the usual risks, it is often the last alternative for improving general health. Since the tear in the esophagus leads to high blood loss, it is particularly crucial for the course of the disease that adequate blood transfusions are given. Otherwise, the prognosis worsens and consequential disorders occur.
prevention
Since excessive alcohol consumption is one of the main causes of the development of this disease, those affected should keep their alcohol consumption moderate or, if necessary, refrain from alcohol altogether. Bulimia sufferers should undergo psychotherapy early because the constant vomiting not only attacks the teeth but also the esophageal mucous membranes, worsens their general well-being and thus promotes Mallory-Weiss syndrome.
People with reflux syndrome should avoid highly acidic foods and eat smaller meals, as large, high-fat meals encourage reflux from the stomach into the esophagus.
Aftercare
In most cases Mallory-Weiss syndrome is associated with recurring complications and complaints, all of which generally reduce the person's quality of life. The disease cannot heal itself, so that permanent treatment by a doctor is necessary.
In general, follow-up care focuses on the severely weakened circulation of the person affected, so that they can no longer participate in strenuous or physical activities. A healthy lifestyle, which includes avoiding alcohol as far as possible and getting enough exercise, can help to strengthen the body and thus general well-being. A corresponding change in diet is also recommended in order not to unnecessarily irritate the damaged esophagus. If Mallory-Weiss syndrome is not treated, it can also lead to a reduced life expectancy for those affected.
You can do that yourself
Acute bleeding occurring as part of Mallory-Weiss syndrome must always be treated by a doctor. It is then extremely important to take care of the gastrointestinal tract during the healing phase and, if possible, to eliminate the causes that led to the occurrence of the disease.
Both bulimia and alcohol addiction require medical and therapeutic treatment, and attending a self-help group can be helpful. If the cause is reflux disease, all foods that stimulate gastric acid production should be avoided as far as possible. These are mainly fatty, spicy and very sugary foods, coffee, alcohol and chocolate. Several small meals spread out over the day are better tolerated than three large ones. Anyone who suffers from heartburn at night should raise the head of the bed a little higher and have dinner at least three hours before going to bed. If heartburn does occur, soaked oatmeal, rusks or healing clay dissolved in water will alleviate the symptoms. Chamomile tea and cheese poplar tea have anti-inflammatory effects and protect the damaged mucous membrane of the esophagus. Aloe vera juice is also a proven home remedy for heartburn.
Stress can increase the production of stomach acid. A conscious slowing down of everyday life, learning relaxation techniques and regular sporting activities promote well-being. Meals, in particular, should always be taken in peace and quiet.
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