Median Arcuate Ligament Syndrome (MALS)

Posted by Kari Ulrich, Alumna Mentor @kariulrich, Dec 26, 2016

I am looking for other patients that have been diagnosed with Median Arcuate Ligament Syndrome. Although it is caused by compression of the celiac artery many people experience abdominal pain after eating, diarrhea, food avoidance. Usually the first doctors they see are GI doctors. It is a diagnosis that is made after everything else is ruled out. I am curious if anyone else has had surgery?

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@atjmoney

Hello,
My daughter had the ultrasound they determined the nerve was narrow and there was fibrous tissue around the nerve. The surgery was to remove the tissue in hopes of relieving the nerve. It was unsuccessful and we're back at square 1. The next phase is the full surgery, I'm a little concerned about the healing process. She's a college athlete and very anxious to get back on the court. Right now her eating has regressed less than 800 calories a day, not good. she's starting to have pain with exercise, any suggestions on controlling the nausea and abdominal pain. I'm looking at cannabis and other alternative meds. Your thoughts?

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I have a Florida medical card and use it for nausea and it is great as an appetite inducer. There are different forms of cannabis, I use RSO which is a concentrate. You can put RSO on your skin, cook with it but you do not inhale it. I put a bit of peanut butter on a cracker and squeeze a small amount out of the syringe on top of the peanut butter. But you can get edibles, tinctures, capsules or a syringe is what I use. It helps me sleep too. I use it sparingly but that is what I found to work best for me. It doesn’t give me a high which I don’t want it to but has helped me dealing with my issues. Do some research, there is so much out there. Some of the dispensaries sites are great on explaining what is what. I can’t remember the exact site, but you type in say nausea, it will bring up strands that work best for nausea You have to find what works best for your daughter. I do hope she finds relief soon.

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I do and I will be 78 this month
Not a good candidate for open surgery maybe Robiotic. I am having a nerve block this month at Yale . I have been eating small meals often and having a drink once a day helps the pain. I do not take pain meds.

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@kariulrich

How are you doing since your diagnosis??

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I was diagnosed with Mals for 2 years now having a nerve block at Yale this month. I am 76 not a good candidate for open surgery maybe robiotic.

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@azizamin

Hello everyone,

I’m new to this platform and wanted to briefly introduce myself and share my situation. I was recently diagnosed with Median Arcuate Ligament Syndrome (MALS) and Nutcracker Syndrome after several months of persistent abdominal pain and related symptoms. After undergoing multiple diagnostic tests, my vascular surgeon confirmed the presence of both conditions.

During my consultation, I was informed that both laparoscopic and open surgical approaches are available to treat MALS. However, my surgeon personally recommended open surgery, citing greater access and precision in releasing the ligament. The expected hospital stay is around 10 days, and I was advised that full recovery may take up to 2 months, with limited physical activity during this period. Rehabilitation may also be required in some cases.

I would deeply appreciate hearing from others who have undergone either open or laparoscopic MALS surgery — particularly regarding:

How did you feel immediately after surgery and during the first few weeks of recovery?

Were your symptoms fully resolved, partially improved, or did they persist?

Did anyone experience complications, recurrence, or need for further procedures?

How did you manage nutrition, digestion, and physical activity post-op?

If you also had Nutcracker Syndrome, was it addressed separately, or did one surgery help both conditions?

I’m also concerned about the possibility of recurrence, nerve-related pain after surgery, and whether opting for open surgery over laparoscopy truly offers better outcomes in the long term.

Thank you in advance to anyone willing to share their experiences, advice, or support. It means a lot as I try to make an informed and confident decision about my next steps.

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I was diagnosed with mals in 2019. I had open surgery and was in the hospital for 4 days. The recovery s a long one especially for me. It took many tests that were all negative and 15 years for a diagnosis. The recovery is a long one. If mals is the only problem and you’re young, the recovery is not as long. Find someone who can treat both vascular compressions. A group on Facebook called Mals Awareness helped me understand and learn more. You’re not alone!

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Hello everyone,

I’m new to this platform and wanted to briefly introduce myself and share my situation. I was recently diagnosed with Median Arcuate Ligament Syndrome (MALS) and Nutcracker Syndrome after several months of persistent abdominal pain and related symptoms. After undergoing multiple diagnostic tests, my vascular surgeon confirmed the presence of both conditions.

During my consultation, I was informed that both laparoscopic and open surgical approaches are available to treat MALS. However, my surgeon personally recommended open surgery, citing greater access and precision in releasing the ligament. The expected hospital stay is around 10 days, and I was advised that full recovery may take up to 2 months, with limited physical activity during this period. Rehabilitation may also be required in some cases.

I would deeply appreciate hearing from others who have undergone either open or laparoscopic MALS surgery — particularly regarding:

How did you feel immediately after surgery and during the first few weeks of recovery?

Were your symptoms fully resolved, partially improved, or did they persist?

Did anyone experience complications, recurrence, or need for further procedures?

How did you manage nutrition, digestion, and physical activity post-op?

If you also had Nutcracker Syndrome, was it addressed separately, or did one surgery help both conditions?

I’m also concerned about the possibility of recurrence, nerve-related pain after surgery, and whether opting for open surgery over laparoscopy truly offers better outcomes in the long term.

Thank you in advance to anyone willing to share their experiences, advice, or support. It means a lot as I try to make an informed and confident decision about my next steps.

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@graceym1

Not true. You can lose and gain weight with masks. I have! and I have 70 compression.

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Mals I mean.

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@bunty

Went to vascular surgeon. He said if no symptoms and if i can gain weight back (by eating more), then this CT scan was a false positive. Do not worry about MALS

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Not true. You can lose and gain weight with masks. I have! and I have 70 compression.

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@graceym1

You need to get to a vascular surgeons office or cardiology and have a special ultrasound performed with breathing protocols. This is the definitive test for Mals and the amount of compression you have. Also you’ll need to go to gi dr to have tests done to rule out things that may be similar in symptoms like barium swallow, ph impedence test, there are many that I had. Good luck! Keep in touch. Let us know how you’re doing. 🙏🏻

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Went to vascular surgeon. He said if no symptoms and if i can gain weight back (by eating more), then this CT scan was a false positive. Do not worry about MALS

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@graceym1

You need to get to a vascular surgeons office or cardiology and have a special ultrasound performed with breathing protocols. This is the definitive test for Mals and the amount of compression you have. Also you’ll need to go to gi dr to have tests done to rule out things that may be similar in symptoms like barium swallow, ph impedence test, there are many that I had. Good luck! Keep in touch. Let us know how you’re doing. 🙏🏻

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Tx !

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