Mallory-Weiss Syndrome: Causes, Symptoms, and Treatment
Medically reviewed by Harsha Moole, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Mallory-Weiss Syndrome?
A gastroenterologist, a doctor who treats the digestive system, usually finds and treats a Mallory-Weiss tear. A general doctor or an emergency doctor may see you first if you are bleeding. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is Mallory-Weiss syndrome?
Mallory-Weiss syndrome is a tear in the mucous membrane, the soft inner lining, of the lower esophagus or upper stomach. The esophagus is the tube that carries food to the stomach. The tear happens near the place where the two join. Doctors also call it a Mallory-Weiss tear.
The tear may bleed. Other problems can cause similar symptoms, such as peptic ulcers, gastritis (an inflamed stomach lining), and swollen veins in the esophagus.
Symptoms
Symptoms often follow a bout of hard vomiting or retching, which is the strong urge to vomit. Common signs include:
- Vomiting blood, which may be bright red or look like coffee grounds.
- Bloody stools, or stools as dark as tar.
- Pain in the belly.
Most of the time the bleeding stops on its own. If a lot of blood is lost, a person can go into shock and collapse. In very rare cases, the bleeding can become life-threatening.
Causes and who gets it
Mallory-Weiss tears are most often caused by forceful or long-term vomiting or coughing. They may also be caused by seizures. Any condition that leads to violent and lengthy bouts of coughing or vomiting can cause these tears.
Other causes include chronic alcoholism, severe injury to the chest or belly, chronic hiccups, intense snoring, heavy lifting and straining, hiatus hernia, and CPR. Cancer patients may develop a tear as a complication of chemotherapy.
The tear is more common in people with alcoholism. It appears to affect more men than women. Ages vary, with a peak at ages 40 through 60, and some children have been affected.
How doctors diagnose it
A doctor asks about your symptoms and any recent vomiting or coughing. A complete blood count (CBC) blood test may show a low hematocrit, which means fewer red blood cells than normal.
The usual way to confirm the tear is an endoscopy, an exam of the esophagus with a scope. The full name is esophagogastroduodenoscopy (EGD). It is more likely to be done when there is active bleeding or a high risk of bleeding again.
Treatment
The tear usually heals in a few days without treatment. In most cases, bleeding stops without treatment within a few hours.
If treatment is needed, the tear may be fixed during an EGD with clips, electrocoagulation (sealing with an electrical current), or an injection of epinephrine. Medicines that suppress stomach acid, called proton pump inhibitors, are typically given for a short time afterward to lower the chance of bleeding again.
If a lot of blood is lost, a person may need blood transfusions. Surgery is rarely needed. For massive bleeding that cannot be controlled, a procedure called embolization may be needed to block the bleeding area.
Repeated bleeding is uncommon, and the outcome is most often good. Cirrhosis of the liver and problems with blood clotting make future bleeding more likely.
Treatments to relieve vomiting and coughing may reduce risk. Avoid excessive alcohol use.
When to see a doctor
Call 911 or go to the emergency room if you vomit blood, pass bloody stools or stools as dark as tar, have bleeding that will not stop, faint or lose consciousness, or have severe belly pain.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. A DPC doctor can review your symptoms, order blood tests, and refer you to a gastroenterologist for an endoscopy. They can also follow up on causes such as alcohol use or repeated vomiting.
Common questions
Is a Mallory-Weiss tear serious?
It can be, because the tear may bleed. In most cases the bleeding stops without treatment. In very rare cases, the bleeding can become life-threatening.
How long does a Mallory-Weiss tear take to heal?
The tear usually heals in a few days without treatment.
Does a Mallory-Weiss tear need surgery?
Surgery is rarely needed. Most tears heal on their own, and a tear that does not stop bleeding may be fixed during an EGD.
Can Mallory-Weiss syndrome be prevented?
It may be possible to lower your risk. Treatments to relieve vomiting and coughing may reduce risk, and avoiding excessive alcohol use helps.
Sources
- MedlinePlus - Mallory-Weiss tear
- National Organization for Rare Disorders (NORD) - Mallory Weiss Syndrome
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
