Hi. These symptoms exactly match mine. I have had 8 years undiagnosed except for Small Intestinal Bacterial Overgrowth (SIBO). Can MALS cause SIBO does anyone know or have? I am going to the Scottsdale MAYO clinic next week. Is there anything I should ask them or tell them to help them diagnose this if it is the condition I'm struggling with? Haven't been able to eat for 2 months so living on elemental diet which can even cause pain. Lost a lot of weight. I usually have exacerbations like this that put me in bed with epigastric pain and what feels like overwhelming autonomic nervous system symptoms but usually they come right in days to maybe 2 weeks but never this long so know I'm getting worse and I need a diagnosis. SIBO is not a diagnosis - there is always an underlying cause and I have had most others, except for SMAS, excluded. Diet modification does nothing. Medication, other than pain killers taking the edge off it and lorazepam calming me down, otherwise do nothing. It is very waxing and waning in symptoms, night or day. Exercise, stress and eating anything are the triggers. Sounds just like MALS to me. Should I also ask the specialists there to test me for vascular and connective tissue disorders? Thanks so much, this is all new but hopeful finally