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Median Arcuate Ligament Syndrome (MALS)

Digestive Health | Last Active: 6 days ago | Replies (1138)

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@kariulrich

I understand your concerns with the article but I believe it is a relavent and necessary topic. You may have misunderstood the conclusions are that patients that have undergone surgical intervention have improved quality of life. I believe many MALS patients experience situational anxiety and depression, I definitely have. That does impact the success of a surgery...any surgery not just MALS. Also many come into surgery already on pain medication and that also impacts the outcomes of surgical success according to the research available. I believe this article is supportive of the MALS patient as a whole, and address issues that a relavent to all of us.

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Replies to "I understand your concerns with the article but I believe it is a relavent and necessary..."

Hi @kariulrich
Although the article seems to champion surgery for MALs sufferers the fact that it couples psychiatric comorbidities with MALs sends out the wrong impression. With such a low amount of people in the study group percentages become skewed giving rise to conclusions that are somewhat biased. A larger study group would have been ideal. We all know how much specialist love to drop percentages as evidence to justify what they are saying. A greater concern is there is no mention of a control group in the study. This would tell us if psychiatric comorbidities are a factor in the end result and quality of life of participants.

I’m not sure if you had a look at the evaluating factors for the psychiatric comorbidities; Beck’s Anxiety Inventory, Beck’s Depression Inventory and the Eating Disorder Examination Questionaire. These indexes are suitable for workplace and everyday environments, they are hardly suitable for a MALs sufferer. Many of the questions we would score high because of the condition not because how we feel.

As you mentioned many MALs sufferers may have suffered from situational anxiety and depression; a subject I brought up a while a go. Doctors need to understand that every sufferer is different and may suffer at some point to some degree a state of anxiety or depression; I agree we need to be in the right frame of mind preoperatively in order to achieve greater success in the degree of quality of life postoperatively.

The length of time and degree of painfulness the person has suffered may well determine the frame of mind that person is in. I look at MALs sufferers as long term torture victims. First and foremost we are not in control, We don’t always know when it will hit, we don’t know just how much pain will be inflicted and we never know for how long it will last; all the hallmarks of being repeatedly tortured. All this and yet most of us still smile and generally hide our painful nature.

We are so widely connected around the world a better more comprehensive study could be devised. I really think we deserve more than a 100 person study!