Endoscopy image
Red stripes like those on the rind of a watermelon can be seen on the inside lining of the stomach. These are widened small blood vessels. From time to time they can bleed and cause iron deficiency and anaemia.
What is watermelon stomach?
Watermelon stomach, whose medical name is gastric antral vascular ectasia (GAVE), is a condition that comes about when small blood vessels in the inside lining of the stomach become widened.
At gastroscopy these vessels are seen as red stripes. Because they look like the stripes on the rind of a watermelon, the condition is commonly called “watermelon stomach”.
It is not cancer. The widened vessels can bleed easily, however, and over time can cause anaemia.
What are the symptoms?
Some patients may have no symptoms at all. The commonest problem is slow blood loss from the inside lining of the stomach that goes unnoticed.
For this reason patients may have:
- Weakness and getting tired quickly
- Iron deficiency and anaemia
- Dizziness and palpitations
- Breathlessness
- Sometimes black stools
Why does it happen?
The exact cause is not known. It can be seen together with certain liver, kidney and immune system diseases. It can also appear, however, in people who do not have these diseases.
How is it diagnosed?
The diagnosis is usually made by gastroscopy. The typical red stripes of blood vessels on the inside lining of the stomach are seen. When needed, blood tests are used to look for anaemia.
How is it treated?
Treatment is planned according to how much bleeding and anaemia there is.
In mild cases iron treatment and follow-up may be enough. If bleeding continues, the bleeding vessels can be sealed in a controlled way during gastroscopy using a method called argon plasma coagulation (APC).
In some patients the procedure may need to be repeated several times. When needed, other endoscopic treatments can also be used.
When should you see a doctor?
If you have unexplained anaemia, constant weakness or darkening of the stool, you are advised to see a gastroenterologist.
If you vomit blood, pass tar-like black stools or faint, you should seek emergency medical care.
Remember: watermelon stomach is not cancer. Because it can cause blood loss that goes unnoticed for a long time, however, proper assessment and, when needed, treatment are important.
Sources
- Prof. Ali Tüzün İnce, MD — personal endoscopy archive