<prompt> About Mallory Weiss syndrome true is -Gastrointestinal refluxObesityTumour at gastroesophageal junctionSeen in alcoholics  <response>: Mallory - Weiss syndrome is characterized by a mucosal tear at the gastroesophageal junction following a bout of forceful retching or vomiting, coughing or straining.- The tear is partial thickness, extends through the mucosa and submucosa, but not through the muscular layer compare this with Boerhaave syndrome in which the tear is full thickness penetrating completely through all the layers of esophageal wall with spillage of contents into the mediastinumThe clinical picture consists of acute upper gastrointestinal bleeding following bouts of retching or vomitingThe mean age of patients is older than 60 years. 80 are men - Sabiston 17e, p 1254.Majority of patients are alcoholicsOther frequent associations with Mallory-Weiss tears areA hiatal herniaNSAIDs abuseDisease-related bleeding diathesis.ManagementIn the majority -90 of patients the bleeding stops spontaneously and only supportive therapy is required.Persistent bleeding is managed byEndoscopic electrocoagulationif failsAngiographic techniques embolizationif failsSurgery: Laparotomy with high gastrotomy with oversewing of the linear tear.It is important to rule out the diagnosis of variceal bleeding in cases of failed endoscopic therapy by a thorough examination of the GE junction. Recurrent bleeding from a Mallory-Weiss tear is uncommon.Note that the Sengstaken - Blakemore tube will not be able to stop the bleeding in Mallory-Weiss syndrome as the bleeding is arterial and the pressure in the balloon is not sufficient to overcome the arterial pressure. 