Mallory Weiss tears refer to ruptures of the inner esophageal wall that sometimes extend into the upper stomach due to straining, often as a result of vomiting, coughing, or other trauma. Men between ages 40 and 60 who drink heavily are at the greatest risk, but patients with bulimia, conditions causing frequent vomiting, and/or esophageal conditions are also at increased risk. Symptoms include blood in vomit, dark stools, and dizziness and fainting due to blood loss and resulting anemia. Internal bleeding may also lead to shock. Though typically Mallory Weiss tears heal on their own or with the prescription of proton pump inhibitors, they sometimes requires endoscopic or surgical procedures.