Median Arcuate Ligament Syndrome (MALS)

The original surgeon I feel was very good. He took the time to listen to me and was very understanding. He was the only one who believed me unlike others I dealt with. My first vascular surgeon laughed at me and said that your celiac artery wasn't the problem. That it was all just in my head. It wasn't until Dr. Lowery sent me out for another Doppler US. My velocities were from 580 to 620. After that, the original vascular surgeon sent a certified letter stating my health was in danger and I needed to see him ASAP. LOL! So I'm very reluctant to see this new vascular surgeon her name is Jenny Cho. She's out of KU MED CENTER IN KS. So I have an appointment on April 8th and we will see what she wants to do. I feel she will just blow me off as the other did. It sad people go to their doctors and they just look at you as nothing is wrong. It's their arrogance that comes through when they don't know about MALS. However, I believe I found a good general surgeon who listens and is willing to do what is right for me.

Jayson, I can relate. When I had my initial diagnosis in 2015 I saw so many GI docs and most of them were so incredibly dismissive. My first one seemed to have only one answer: take more prilosec, take protonix, double up on protonix. So I finally said to him "is that your only answer, take more acid suppressants?" and he got visibly angry at me and said "do you want to get well?" So condescending. Then I had an ER doc accuse me of just being a drug seeker and sending me home after zero tests. After doing every GI test imaginable I finally saw an RN at an urgent care office who looked at my history and offered to make some calls for me on her lunch break. She set me up with a young GI specialist who ordered a HIDA scan (all clear) and the mesenteric artery ultrasound that finally diagnosed me. If it wasn't for those two, I have no idea how much longer it would have gone on.

Unfortunately, like you, I am having a recurrence of symptoms after 5 years. Last night was the worst night I've had since 2015, sharp pain building up, had to take an oxycodone and sleep propped up, then I still woke up nauseous. That has been my worst symptom and thankfully this time around, I am not having too much trouble eating. Once I get up and move around the nausea fades but pain persists. I'm getting a nerve block done next week and hoping the pain care center will also offer me some help over the next few weeks while I wait for what I expect to be a second surgery.

As far as seeing a new surgeon, I would at least google search and see what other patients have reported. The one I've been consulting is very young but has a special interest in MALS. Another surgery is scary to think about but so is living with constant bouts of pain/nausea.

Hi @chicken

Again, I have to agree with @lasirvent, Lactulose is a great way to increase intestinal motility. I was given it many years ago after a laparotomy which basically caused my intestines to shut down completely. It took a while to get going again but the Lactulose worked.

I stopped using Lactulose in favour of a more natural remedy, so I started eating liquorice daily. I didn't eat too much and it is important to let you know that eating a lot of liquorice daily can reduce your potassium levels which in turn can cause high blood pressure. It is always best to discuss with your primary practitioner as a lot of liquorice can interact with certain meds like warfarin.

However, the benefits of eating liquorice for digestive problems and other conditions can be great, it is thought to have antimicrobial, anti-inflammatory and antiviral properties too. Just make sure that if you buy liquorice sweets, they actually contain liquorice plant extract, as many sweet sold as liquorice don't have any liquorice in them at all. You can get deglycyrrhizinated liquorice as over the counter supplements, this stops the possibility of those side effects as the cause, (glycyrrhizic acid) is extracted. But I'm a liquorice sweet fan and enjoy the yummy taste of the sweets! Look up the benefits of deglycyrrhizinated liquorice if you are wanting an over the counter remedy.

Mark

Jayson, I can relate. When I had my initial diagnosis in 2015 I saw so many GI docs and most of them were so incredibly dismissive. My first one seemed to have only one answer: take more prilosec, take protonix, double up on protonix. So I finally said to him "is that your only answer, take more acid suppressants?" and he got visibly angry at me and said "do you want to get well?" So condescending. Then I had an ER doc accuse me of just being a drug seeker and sending me home after zero tests. After doing every GI test imaginable I finally saw an RN at an urgent care office who looked at my history and offered to make some calls for me on her lunch break. She set me up with a young GI specialist who ordered a HIDA scan (all clear) and the mesenteric artery ultrasound that finally diagnosed me. If it wasn't for those two, I have no idea how much longer it would have gone on.

Unfortunately, like you, I am having a recurrence of symptoms after 5 years. Last night was the worst night I've had since 2015, sharp pain building up, had to take an oxycodone and sleep propped up, then I still woke up nauseous. That has been my worst symptom and thankfully this time around, I am not having too much trouble eating. Once I get up and move around the nausea fades but pain persists. I'm getting a nerve block done next week and hoping the pain care center will also offer me some help over the next few weeks while I wait for what I expect to be a second surgery.

As far as seeing a new surgeon, I would at least google search and see what other patients have reported. The one I've been consulting is very young but has a special interest in MALS. Another surgery is scary to think about but so is living with constant bouts of pain/nausea.

Jayson, I can relate. When I had my initial diagnosis in 2015 I saw so many GI docs and most of them were so incredibly dismissive. My first one seemed to have only one answer: take more prilosec, take protonix, double up on protonix. So I finally said to him "is that your only answer, take more acid suppressants?" and he got visibly angry at me and said "do you want to get well?" So condescending. Then I had an ER doc accuse me of just being a drug seeker and sending me home after zero tests. After doing every GI test imaginable I finally saw an RN at an urgent care office who looked at my history and offered to make some calls for me on her lunch break. She set me up with a young GI specialist who ordered a HIDA scan (all clear) and the mesenteric artery ultrasound that finally diagnosed me. If it wasn't for those two, I have no idea how much longer it would have gone on.

Unfortunately, like you, I am having a recurrence of symptoms after 5 years. Last night was the worst night I've had since 2015, sharp pain building up, had to take an oxycodone and sleep propped up, then I still woke up nauseous. That has been my worst symptom and thankfully this time around, I am not having too much trouble eating. Once I get up and move around the nausea fades but pain persists. I'm getting a nerve block done next week and hoping the pain care center will also offer me some help over the next few weeks while I wait for what I expect to be a second surgery.

As far as seeing a new surgeon, I would at least google search and see what other patients have reported. The one I've been consulting is very young but has a special interest in MALS. Another surgery is scary to think about but so is living with constant bouts of pain/nausea.

Look at this site!

That’s funny! I used to eat licorice all the time! I’m going to give that a try. What brand do you use?

Yesterday I had a celiac plexus block done by Dr. Krutsch in Denver. I'm happy to report that it worked. This was just a diagnostic block so it's starting to wear off this morning, but it was so incredibly nice to feel "normal" again for a while. I had forgotten what that felt like. What also surprised me is I have had diffuse right flank pain ever since my first MALS surgery in 2015 and that also went away completely. I am hopeful that if I have a second surgery done all of this pain and nausea will go away. The surgeon I've been working with is most likely going to want to do an open procedure similar to what Dr. Hsu does.

If anyone out there suspects they have MALS I would really recommend trying to get a celiac plexus block to see if it provides significant relief.