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← Return to Median Arcuate Ligament Syndrome (MALS)
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Median Arcuate Ligament Syndrome (MALS)
Digestive Health | Last Active: 4 hours ago | Replies (1229)Comment receiving replies
Hello. I've been on here before and was diagnosed with MALS and had laparoscopic that was converted to open in 2019. I was pain-free for a year and now started having the old symptoms return. Pain after eating, bloating, and nausea. So I decided to go back to my primary and he sent me to get a Doppler US which was difficult in seeing my celiac artery because of a large gas bubble. However, she did get my velocity clocked in at 261 which the doctor said that my the celiac artery was probable 70% blocked. So now I went to my surgeon Dr. Lowery on what I should do since I was still having pain. He said that it's possible that the artery could have closed up after surgery, or the scar tissue has built up and is causing the artery issues. So now I'm waiting to see a vascular surgeon to see what the next step is. Moreover, Dr. Lowery said the worst-case scenario would be opening me back up again and removing the scar tissue. Which he said it could be a very long surgery and a very risky one. So, has anyone, had the experience of this reoccur and what was the outcome? Thanks
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Hi @jayson
Throughout this thread there has been a theme whereby some pain returns, sometimes caused by scar tissue. I think MALs diagnosis and surgery is still in its infancy, as such patients don't always get the best care before, during and after surgery. In the UK we are even further behind you in not just doctors accepting MALs exist, but in treating the condition.
The one thing I have learned from this group is I must be educated on the condition, especially when talking to doctors and be organised. For me that also means organising the multidisciplinary team that will care for me before and after surgery. My primary care physician is the focal point for all. I am also under a Gastroenterologist, a Vascular surgeon who will perform the surgery, a Pain specialist and a Dietician. There is also a Physiotherapist who will come onboard after the surgery. I requested this to try and combat the effects of scar tissue causing pain after the surgery.
@sclindajanssen posted a very interesting research paper a few weeks ago (Interprofessional Management of MALs related to Lumbar Lordosis and Hip Dysplasia.) Although it is quite a technical read there are elements in there of use to all, especially around exercise. @sclindajanssen also discusses how MALs affects other body systems with a wide array of symptoms in a patient.
Both @lasirvent and @jhmontrose have mentioned lower rib squeeze and scar tissue in their posts. My advice to anyone going for surgery is to employ the services of a physiotherapist for post-surgery care. This would apply more for those going for open surgery, but still can be considered and have benefits for those having laparoscopic surgery.
It would be interesting to get an update from @sclindajanssen and get her thoughts on physiotherapy after MALs surgery.