What is the diagnosis for vomiting blood after heavy drinking?

The diagnosis of vomiting blood after heavy drinking that is often most associated with a Mallory-Weiss tear involves a tear in the mucosa at the junction of the stomach and esophagus, typically caused by forceful or prolonged vomiting after excessive alcohol consumption. The mechanism here is that heavy drinking can irritate the lining of the stomach and esophagus, and if vomiting occurs, the increased pressure can lead to a tear, resulting in hematemesis (vomiting blood).

In this context, while esophageal varices are also a potential reason for vomiting blood in patients with a heavy drinking history due to liver cirrhosis, they usually present with more chronic symptoms and are typically associated with a more severe underlying liver disease. Similarly, though gastritis can lead to upper gastrointestinal bleeding and is common among heavy drinkers due to irritative effects of alcohol on the gastric mucosa, the acute presentation of blood following a vomiting episode is more characteristic of a Mallory-Weiss tear. Eosinophilic esophagitis, on the other hand, is primarily an allergic condition resulting in esophageal inflammation and is not typically linked to acute episodes of vomiting blood related to heavy drinking.