Welcome, @ukmalsman. Mayo Clinic Connect is all about meeting other members who experience things similar to yourself, share information, and encourage one another – I'm so glad you've joined this group and shared some incredible insights.

It's interesting that you note, "Currently there is very little research into MALs with consultants looking at the condition with blinkers on unable to even agree on how the pain is caused." I agree – the diagnosis of MALS has been the subject of much debate.There are several factors (about the lack of clarity) that I thought I'd mention.

Because the cause of MALS is not clear and symptoms may persist even after surgical treatment, its diagnosis is considered controversial. The challenge lies in the fact that it mimics other GI symptoms. Therefore, MALS is considered to be a diagnosis of exclusion – every other possibility that might be causing pain must be ruled out before making a clinical diagnosis.

In MALS, the medial arcuate ligament compresses the celiac artery, reducing blood flow to the stomach/intestines; surgery, where the ligament is cut away from the artery, doesn’t always get rid of the pain and symptoms. Many surgeons reason that if compression of this artery was causing the pain and other symptoms, then eliminating the compression should get rid of it – which may not be the case.
Although, I've learned that it's become less challenging to treat, since surgical intervention now includes removing the celiac ganglion, which is the mass of nerves in that area (some call it the “solar plexus”) because pressure on the nerves may be causing the abdominal pain. https://pdfs.semanticscholar.org/d6b6/4ec69d1cd3ef5f02036362f960d3b0be0181.pdf

That being said, I'd also like to mention these very encouraging published studies that show the tremendous advancements taking place (imaging techniques, laparoscopic surgery), which would help in establishing diagnoses of this condition:
- Contemporary management of median arcuate ligament syndrome provides early symptom improvement https://bit.ly/2Rrfop4
- A predictive model for patients with median arcuate ligament syndrome https://bit.ly/2pDJQzN

@ukmalsman, if there is one thing I've learned from the members of Connect, including you, is that you should never give up until you find the right physician or the right treatment that can help you in the best possible way. I'm certain @kariulrich will join in soon, and I look forward to seeing more posts from you.