Watermelon Stomach: Symptoms, Causes, Diagnosis & Treatments

The condition in which dilation of the blood vessels in the stomach causes a potential danger of excessive internal bleeding is known medically as GAVE (gastric antral vascular ectasia). Since the blood vessels make red streaks inside and outside the stomach just like the streaks on a watermelon, this condition is generally referred to as watermelon stomach.

Although women above the age of 50 who have been diagnosed with any autoimmune disease, irritable bowel syndrome, an abdominal injury or cirrhosis are most likely to suffer from this condition, it can happen to anyone.

Symptoms of Watermelon Stomach

Gastrointestinal bleeding is the most prominent sign of watermelon stomach which can cause following symptoms:

  • Bloody stool
  • Vomiting blood (hematemesis)
  • Anemia

In addition to these symptoms, patients of watermelon stomach might also experience other symptoms like chronic headaches, shallow breathing and feelings of weakness or fatigue. Having difficulty concentrating, chest pain, heart palpitations, confusion and lightheadedness are also common symptoms experienced by people who have suffered a lot of blood because of this condition. It is important to immediately consult a doctor if you experience any of these symptoms so that your condition is properly diagnosed and treated as soon as possible.

Causes of Watermelon Stomach

Although the exact cause of watermelon stomach remains a mystery, people suffering from chronic conditions like systemic sclerosis, cirrhosis, CREST syndrome and autoimmune disease are often diagnosed with it.

Distension caused by vasculitis, disorders that hamper the functioning of the gastrointestinal system, trauma to the abdomen, cirrhosis or grave’s disease is the reason for the appearance of the dilated blood vessels in the antral part of the stomach. People who are most susceptible to develop this condition usually have large bowel obstruction, irritable bowel syndrome and chronic constipation. You can expect severe hemorrhaging and subsequent anemia when eruption of the dilated blood vessels occurs in the stomach.

Diagnosis of Watermelon Stomach

Differential diagnosis: Constructing an adequate differential is important for diagnosis of watermelon stomach as several diagnoses can be reached from its symptoms indicating conditions that have vastly diverse treatments. Common causes that are to be included in an adequate differential include portal hypertension and gastric/duodenal ulcer. Gastric antral vascular ectasia, hemobilia, Cameron lesions, Dieulafoy Lesions, aortoenteric fistulas, upper gastrointestinal tumors, hemosuccus pancreatic us and portal hypertensive gastropathy are among the intermittent causes that are to be included in an adequate differential.

Diagnosis: An endoscopic biopsy is the only conclusive way of diagnosing GAVE syndrome. An endoscopy can easily reveal the characteristic watermelon stripes of this condition. The watermelon streaks are in the form of flat, erythematous stripes in longitudinal rows that radiate into the antrum after originating from the pylorus.

In patients having portal hypertension, the presentation of the watermelon streaks is different. Such people might not have the radiating patterns and instead have diffuse antral angiomas. In both cases, tagged red blood cell scan, CT scan or endoscopic ultrasound can be used for confirming the diagnosis. In addition to this, the histopathological feature of GAVE can be characterized by spindle cell proliferation, vascular ectasia and fibrohyanlinosis. Risk indication in GAVE patients that have systemic sclerosis can be done through the use of anti-RNA polymerase III auto-antibodies.

Treatment of Watermelon Stomach


Argon plasma coagulation or endoscopic laser surgery are the two treatment methods available for watermelon stomach. Endoscopy is used for performing both these procedures. The argon plasma coagulation makes use of electric current and argon gas for sealing bleeding or irregular tissue while endoscopic laser surgery makes use of laser light for treating bleeding blood vessels.


Certain drugs are prescribed for patients in some cases for controlling or stopping the gastrointestinal bleeding. Treatment of watermelon stomach has been carried out successfully with hormone therapy (progesterone and estrogen), tranexamic acid and corticosteroids.

At the time of diagnosis, blood transfusions and iron supplements are usually prescribed especially if the bleeding is severe. If the gastrointestinal bleeding cannot be controlled or stopped, then additional transfusions might be required.

Dietary Tips

A healthy diet can go a long way in helping people with watermelon stomach. Avoid stomach-irritating food and drinks such as alcohol, greasy or spicy foods. Instead, try to take good care of your stomach with foods rich in fiber such as whole grains, fruits and vegetables. Besides, the eating habits also matters. Instead of big meals, try smaller but more frequent meals to help with digestion.

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