A Simple Guide to Mallory Weiss Syndrome, Diagnosis, Treatment and Related Conditions

By Kenneth Kee

This book describes Mallory Weiss Syndrome, Diagnosis and Treatment and Related Diseases

Mallory-Weiss syndrome (MWS) is one of the frequent causes of acute upper gastrointestinal (GI) bleeding, featured by the presence of longitudinal superficial mucosal lacerations (Mallory-Weiss tears).

Serious and prolonged vomiting can cause tears in the lining of the esophagus.

Doctors Mallory and Weiss in 1929 accurately depicted this disorder as lower esophageal lacerations happening to patients with repetitive forceful retching and vomiting after excessive alcohol intake.

The esophagus is the tube that joins the throat to the stomach.

Mallory-Weiss syndrome (MWS) is a disorder marked by a tear in the mucous membrane, or inner lining, where the esophagus meets the stomach.

Most tears recover within 7 to 10 days without treatment, but Mallory-Weiss tears can produce considerable bleeding.

Depending on the severity of the tear, surgery may be essential to correct the injury.

These tears happen primarily at the gastroesophageal junction and may extend proximally to involve the lower or even mid esophagus and at times extend distally to involve the proximal portion of the stomach.

The diagnosis of MWS is normally confirmed with endoscopy.

The average esophageal MWS tear is about 2-4 cm in length

Most patients have only one tear of the mucosa near the GE junction.

The tear is just below the GE junction on the lesser curvature of the stomach.

The most frequent cause of MWS is severe or prolonged vomiting.

While this type of vomiting can happen with stomach illness, it also often happens due to chronic alcohol abuse or bulimia.

Heavy alcohol consumption is regarded as one of the most significant predisposing factors since about 50% to 70% of the patients diagnosed with Mallory-Weiss syndrome have a history of alcoholism.

The severity of the upper GI bleeding with Mallory-Weiss syndrome is also documented to be higher with the concurrent presence of portal hypertension and esophageal varices.

The relationship between a hiatal hernia and Mallory-Weiss syndrome is still debatable.

A hiatal hernia was present in a large number of cases with Mallory-Weiss syndrome while a case-control study found no difference in the incidence of a hiatal hernia between patients with Mallory-Weiss syndrome and the control group.

Other risk factors are:
1. Bulimia nervosa,
2. Hyperemesis gravidarum and
3. Gastroesophageal reflux disease (GERD).

In a large number of patients (around 25% of cases), none of these risk factors were identified.

The disorder is triggered by repeated acts of a sudden rise of the intra-abdominal pressure such as retching, vomiting, straining, coughing, cardiopulmonary resuscitation or blunt abdominal traumas.

Iatrogenic Mallory-Weiss syndrome is normally infrequent.

Mallory-Weiss syndrome does not always cause symptoms in mild cases.

This is more frequent in mild instances when tears of the esophagus produce only a small quantity of bleeding and resolve quickly without treatment.

In 85% of cases, the presenting symptom is hematemesis.

The quantity of blood is inconsistent varying from blood-streaked mucus to massive bright red bleeding.

In case of serious bleeding, other symptoms such as melena, dizziness, or syncope can be present.

Upper GI endoscopy is the gold standard for specifically diagnosing Mallory Weiss tears, and treating simple active esophageal bleeding.

Other treatments are:
1. Multipolar electrocoagulation (MPEC),
2. Injection of a sclerosant agent,
3. Argon plasma coagulation (APC), or
4. Endoscopic band ligation.
5. Epinephrine local injection

Surgery is seldom required.

TABLE OF CONTENT
Introduction
Chapter 1 Mallory Weiss Syndrome
Chapter 2 Causes
Chapter 3 Symptoms
Chapter 4 Diagnosi

• Language: English
• Publisher: Kenneth Kee
• Release date: Apr 1, 2021
• ISBN: 9781005423100

Kenneth Kee

Medical doctor since 1972.Started Kee Clinic in 1974 at 15 Holland Dr #03-102, relocated to 36 Holland Dr #01-10 in 2009.Did my M.Sc (Health Management ) in 1991 and Ph.D (Healthcare Administration) in 1993.Dr Kenneth Kee is still working as a family doctor at the age of 74However he has reduced his consultation hours to 3 hours in the morning and 2 hours inthe afternoon.He first started writing free blogs on medical disorders seen in the clinic in 2007 on http://kennethkee.blogspot.com.His purpose in writing these simple guides was for the health education of his patients which is also his dissertation for his Ph.D (Healthcare Administration). He then wrote an autobiography account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.comThis autobiography account “A Family Doctor’s Tale” was combined with his early “A Simple Guide to Medical Disorders” into a new Wordpress Blog “A Family Doctor’s Tale” on http://ken-med.com.From which many free articles from the blog was taken and put together into 1000 eBooks.He apologized for typos and spelling mistakes in his earlier books.He will endeavor to improve the writing in futures.Some people have complained that the simple guides are too simple.For their information they are made simple in order to educate the patients.The later books go into more details of medical disorders.He has published 1000 eBooks on various subjects on health, 1 autobiography of his medical journey, another on the autobiography of a Cancer survivor, 2 children stories and one how to study for his nephew and grand-daughter.The purpose of these simple guides is to educate patient on health disorders and not meant as textbooks.He does not do any night duty since 2000 ever since Dr Tan had his second stroke.His clinic is now relocated to the Buona Vista Community Centre.The 2 units of his original clinic are being demolished to make way for a new Shopping Mall.He is now doing some blogging and internet surfing (bulletin boards since the 1980's) startingwith the Apple computer and going to PC.The entire PC is upgraded by himself from XT to the present Pentium duo core.The present Intel i7 CPU is out of reach at the moment because the CPU is still expensive.He is also into DIY changing his own toilet cistern and other electric appliance.His hunger for knowledge has not abated and he is a lifelong learner.The children have all grown up and there are 2 grandchildren who are even more technically advanced than the grandfather where mobile phones are concerned.This book is taken from some of the many articles in his blog (now with 740 posts) A Family Doctor’s Tale.Dr Kee is the author of:"A Family Doctor's Tale""Life Lessons Learned From The Study And Practice Of Medicine""Case Notes From A Family Doctor"

Book preview

A

Simple

Guide

To

Mallory Weiss Syndrome,

Diagnosis,

Treatment

And

Related Conditions

By

Dr Kenneth Kee

M.B.,B.S. (Singapore)

Ph.D (Healthcare Administration)

Copyright Kenneth Kee 2021 Smashwords Edition

Published by Kenneth Kee at Smashwords.com

Dedication

This book is dedicated

To my wife Dorothy

And my children

Carolyn, Grace

And Kelvin

This book describes Mallory Weiss Syndrome, Diagnosis and Treatment and Related Diseases which is seen in some of my patients in my Family Clinic.

(What You Need to Treat Mallory Weiss Syndrome)

This e-Book is licensed for your personal enjoyment only. This eBook may not be re-sold or given away to other people. If you would like to share this book with another person, please purchase an additional copy for each reader.

If you’re reading this e-book and did not purchase it, or it was not purchased for your use only, then please return to Smashwords.com and purchase your own copy.

Thank you for respecting the hard work of this author.

Introduction

I have been writing medical articles for my blog: http://kennethkee.blogspot.com (A Simple Guide to Medical Disorder) for the benefit of my patients since 2007.

My purpose in writing these simple guides was for the health education of my patients.

Health Education was also my dissertation for my Ph.D (Healthcare Administration).

I then wrote an autobiography account of my journey as a medical student to family doctor on my other blog: http://afamilydoctorstale.blogspot.com.

This autobiography account A Family Doctor’s Tale was combined with my early A Simple Guide to Medical Disorders into a new Wordpress Blog A Family Doctor’s Tale on http://kenkee481.wordpress.com.

From which many free articles from the blog was taken and put together into 800 eBooks.

Some people have complained that the simple guides are too simple.

For their information they are made simple in order to educate the patients.

The later books go into more details of medical disorders.

The first chapter is always from my earlier blogs which unfortunately tends to have typos and spelling mistakes.

Since 2013, I have tried to improve my spelling and writing.

As I tried to bring the patient the latest information about a disorder or illness by reading the latest journals both online and offline, I find that I am learning more and improving on my own medical knowledge in diagnosis and treatment for my patients.

My diagnosis and treatment capability has improved tremendously from my continued education.

Just by writing all these simple guides I find that I have learned a lot from your reviews (good or bad), criticism and advice.

I am sorry for the repetitions in these simple guides as the second chapters onwards have new information as compared to my first chapter taken from my blog.

I also find repetition definitely help me and maybe some readers to remember the facts in the books more easily.

I apologize if these repetitions are irritating to some readers.

Chapter 1

Mallory-Weiss Syndrome

What is Mallory-Weiss syndrome?

Mallory-Weiss syndrome (MWS) is one of the frequent causes of acute upper gastrointestinal (GI) bleeding, featured by the presence of longitudinal superficial mucosal lacerations (Mallory-Weiss tears).

Serious and prolonged vomiting can cause tears in the lining of the esophagus.

Doctors Mallory and Weiss in 1929 accurately depicted this disorder as lower esophageal lacerations happening to patients with repetitive forceful retching and vomiting after excessive alcohol intake.

The esophagus is the tube that joins the throat to the stomach.

Mallory-Weiss syndrome (MWS) is a disorder marked by a tear in the mucous membrane, or inner lining, where the esophagus meets the stomach.

Most tears recover within 7 to 10 days without treatment, but Mallory-Weiss tears can produce considerable bleeding.

Depending on the severity of the tear, surgery may be essential to correct the injury.

These tears happen primarily at the gastroesophageal junction and may extend proximally to involve the lower or even mid esophagus and at times extend distally to involve the proximal portion of the stomach.

The diagnosis of MWS is normally confirmed with endoscopy.

The average esophageal MWS tear is about 2-4 cm in length

Most patients have only one tear of the mucosa near the GE junction.

The tear is just below the GE junction on the lesser curvature of the stomach.

What are the causes of Mallory-Weiss syndrome?

Causes

The most frequent cause of MWS is severe or prolonged vomiting.

While this type of vomiting can happen with stomach illness, it also often happens due to chronic alcohol abuse or bulimia.

Heavy alcohol consumption is regarded as one of the most significant predisposing factors since about 50% to 70% of the patients diagnosed with Mallory-Weiss syndrome have a history of alcoholism.

The severity of the upper GI bleeding with Mallory-Weiss syndrome is also documented to be higher with the concurrent presence of portal hypertension and esophageal varices.

The relationship between a hiatal hernia (protrusion of the upper part of the stomach into the chest cavity through the esophageal opening of the diaphragm) and Mallory-Weiss syndrome is still debatable.

A hiatal hernia was present in a large number of cases with Mallory-Weiss syndrome while a case-control study found no difference in the incidence of a hiatal hernia between patients with Mallory-Weiss syndrome and the control group.

Other risk factors are:

1. Bulimia nervosa,

2. Hyperemesis gravidarum and

3. Gastroesophageal reflux disease (GERD).

All these disorders require regurgitation of gastric contents into the esophagus.

In a large number of patients (around 25% of cases), none of these risk factors were identified.

The disorder is triggered by repeated acts of a sudden rise of the intra-abdominal pressure such as retching, vomiting, straining, coughing, cardiopulmonary resuscitation or blunt abdominal traumas.

Iatrogenic Mallory-Weiss syndrome is normally infrequent.

It can happen as a complication of invasive procedures like upper gastrointestinal endoscopy or trans-esophageal echocardiography (TEE).

Upper gastrointestinal endoscopy has only 0.07% to 0.49% complication rates to develop Mallory-Weiss syndrome, and therefore the risk is low.

Other disorders can result in a tear of the esophagus:

1. Trauma to the chest or abdomen

2. Severe or prolonged hiccups

3. Intense coughing

4. Heavy lifting or straining

5. Gastritis, which