What Is the Treatment of Mallory-Weiss Syndrome?
Mallory-Weiss syndrome can present with active bleeding upon admission, requiring prompt, structured first-line intervention. The treatment goal is hemostasis and resolution of symptoms, typically achieved during inpatient care.
Clinical Goal
Hemostasis achieved and resolution of symptoms. Most patients require hospitalization until both are confirmed.
First-Line Approach — Partial Overview
Management begins with immediate hemodynamic stabilization following airway, breathing, and circulation (ABC) protocols, including intravenous access and fluid resuscitation. The structured regimen also incorporates pharmacologic therapy to reduce gastric acidity and to control nausea and vomiting.
The complete protocol — transfusion criteria, nasogastric decompression, electrolyte and coagulation management, and the full pharmacologic regimen — is available via the link below.
References
DOI: 10.30574/gscarr.2025.23.3.0177
- Immediate resuscitation is necessary for patients presenting with active bleeding upon admission.
- Hemodynamic stability should be assessed through airway, breathing, and circulation (ABC) protocols.
- Establishing good central or peripheral intravenous (IV) access (preferably two lines) alongside fluid resuscitation is crucial and may be lifesaving in cases of massive hemorrhage.
- Proton pump inhibitors (PPIs) and H2 receptor antagonists are administered to reduce gastric acidity, as increased acidity impairs mucosal healing of the stomach and esophagus.
- Additionally, antiemetics such as promethazine and ondansetron may be used to control nausea and vomiting.
- Most patients managed conservatively are typically hospitalized until hemostasis is achieved and symptoms are resolved.
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