Alternate Names: Mucosal lacerations - gastroesophageal junction

Causes and Risks: Forceful or prolonged vomiting or coughing causes the tear which may be followed by vomiting bright red blood, or blood in the stool. Factors contributing to this condition are vomiting, violent coughing attacks, or epileptic convulsions. The incidence is 4 out of 100,000 people.

Prevention: Measures to relieve vomiting and coughing may reduce risk. Avoid excessive alcohol use.

Symptoms:

• vomiting blood, bright red
• stools, bloody

Signs and Tests:

• an EGD (esophagogastroduodenoscopy) showing a tear with bleeding
• a CBC possibly showing low hematocrit

Treatment: The tear usually heals in about 10 days without special treatment. Prescription antacids (proton pump inhibitors or H2 blockers) may be given. If blood loss has been great, blood transfusions may be indicated. Occasionally excessive bleeding may need to be stopped using an endoscope (see EGD). Surgery is rarely required.

Prognosis: Recurrent bleeding is uncommon, and the outcome is expected to be good.

Complications:

• hemorrhage (loss of blood)

Call your health care provider if vomiting blood or if bloody stools develop.