Mine started with attacks too. Before that I'd only have mild nausea after eating that might have been MALS, but it wasn't until one night when it greatly intensified into pain/nausea that lasted throughout the next day that sent me to the ER. That happened several times, 4 ER trips total. I had every GI test done and everything came back normal until an RN in an urgent care office got me an appointment with a young GI specialist who ordered the doppler ultrasound that found MALS.

I thought it was my gallbladder, to be perfectly honest. But after 2 regular ultrasounds and a HIDA scan it was clear that it wasn't. Usually gallbladder attacks result from a fatty meal. MALS doesn't follow that pattern. I suspect my trigger was certain types of exercise. In hindsight, several of my severe attacks happened hours after I'd done stomach crunches or went on a long bike ride, especially if I had a snack during the ride. But everyone's different. Some people have more pain but can eat. Others have very little pain but can't eat at all. And yes, GI docs have a tendency to ignore MALS and assume there's something functional going on with your GI tract.