1. < Digestive Health

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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cberry | @cberry | Nov 26, 2017
In reply to @lexie9409 "Looking for some input. I have had severe diarrhea for several years becoming worse over the..." + (show)
@lexie9409

Looking for some input. I have had severe diarrhea for several years becoming worse over the past year. Started strictly as diarrhea but then turned into stomach pain, nausea, fatigue, as well as the diarrhea. My symptoms vary and recently I have been worked up for MALS. I’m the past I have had colonoscopy/endoscopy with biopsies, ruled out chrons, colitis, microcolitis, diverticulitis, etc. I have tried medications such as dicyclomine, Imodium, colestipol, protonix, amitryptiline, and lexapro (sorry if the spelling is incorrect). I also had my gall bladder out in March of this year for the liver pain and nausea without relief. I have tried diet modification and my pain/diarrhea worsens with exercise.
On a normal basis I have pain under my ribs on the right side (like liver pain) and down the right side of my stomach. I have had a few bouts where the pain has been severe and I was unable to eat. The last bout losing 9-10 lbs. I have in the last two months had two weeks of feeling almost normal with normal stool and no pain with eating. This is always short lived and the symptoms return. I had an ultrasound which showed stenosis of the celiac artery and just had a CT angio which showed mild celiac artery stenosis with a hooked shaped appearance of the celiac artery. I am awaiting speaking with the physician from here but want to know if anyone else has similar issues. Can I have the back and forth with my symptoms if it is MALS? And has anyone else had issues with severe diarrhea (6-10 Times a day). This is taking over my life and I am beyond frustrated.

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Also, if you have facebook, there is a page called MALSPALS, theyre very helpful.

REPLY
cberry | @cberry | Nov 26, 2017
In reply to @lexie9409 "Looking for some input. I have had severe diarrhea for several years becoming worse over the..." + (show)
@lexie9409

Looking for some input. I have had severe diarrhea for several years becoming worse over the past year. Started strictly as diarrhea but then turned into stomach pain, nausea, fatigue, as well as the diarrhea. My symptoms vary and recently I have been worked up for MALS. I’m the past I have had colonoscopy/endoscopy with biopsies, ruled out chrons, colitis, microcolitis, diverticulitis, etc. I have tried medications such as dicyclomine, Imodium, colestipol, protonix, amitryptiline, and lexapro (sorry if the spelling is incorrect). I also had my gall bladder out in March of this year for the liver pain and nausea without relief. I have tried diet modification and my pain/diarrhea worsens with exercise.
On a normal basis I have pain under my ribs on the right side (like liver pain) and down the right side of my stomach. I have had a few bouts where the pain has been severe and I was unable to eat. The last bout losing 9-10 lbs. I have in the last two months had two weeks of feeling almost normal with normal stool and no pain with eating. This is always short lived and the symptoms return. I had an ultrasound which showed stenosis of the celiac artery and just had a CT angio which showed mild celiac artery stenosis with a hooked shaped appearance of the celiac artery. I am awaiting speaking with the physician from here but want to know if anyone else has similar issues. Can I have the back and forth with my symptoms if it is MALS? And has anyone else had issues with severe diarrhea (6-10 Times a day). This is taking over my life and I am beyond frustrated.

Jump to this post

I was diagnosed with MALS in February of this year and underwent surgery in March, i still have persistent diarrhea anywhere from 5 to upwards of 17 times a day. I understand your pain. I have tried everything medication wise too. It is utterly exhausting. The surgery initially helped my vomittng, but after a few months my symptoms came back way worse than before. Im waiting to see if my artery have become compressed again and what we will do after that. I would highly suggest you get a surgeon that knows what theyre doing and has experience with MALS.

REPLY
lexie9409 | @lexie9409 | Nov 26, 2017
In reply to @lexie9409 "Looking for some input. I have had severe diarrhea for several years becoming worse over the..." + (show)
@lexie9409

Looking for some input. I have had severe diarrhea for several years becoming worse over the past year. Started strictly as diarrhea but then turned into stomach pain, nausea, fatigue, as well as the diarrhea. My symptoms vary and recently I have been worked up for MALS. I’m the past I have had colonoscopy/endoscopy with biopsies, ruled out chrons, colitis, microcolitis, diverticulitis, etc. I have tried medications such as dicyclomine, Imodium, colestipol, protonix, amitryptiline, and lexapro (sorry if the spelling is incorrect). I also had my gall bladder out in March of this year for the liver pain and nausea without relief. I have tried diet modification and my pain/diarrhea worsens with exercise.
On a normal basis I have pain under my ribs on the right side (like liver pain) and down the right side of my stomach. I have had a few bouts where the pain has been severe and I was unable to eat. The last bout losing 9-10 lbs. I have in the last two months had two weeks of feeling almost normal with normal stool and no pain with eating. This is always short lived and the symptoms return. I had an ultrasound which showed stenosis of the celiac artery and just had a CT angio which showed mild celiac artery stenosis with a hooked shaped appearance of the celiac artery. I am awaiting speaking with the physician from here but want to know if anyone else has similar issues. Can I have the back and forth with my symptoms if it is MALS? And has anyone else had issues with severe diarrhea (6-10 Times a day). This is taking over my life and I am beyond frustrated.

Jump to this post

I should mention that the pain can be present prior to eating but becomes much worse after eating. Many times causing me to avoid eating, at least until night time when I am home from work and can suffer in the privacy of my home

REPLY
lexie9409 | @lexie9409 | Nov 26, 2017

Looking for some input. I have had severe diarrhea for several years becoming worse over the past year. Started strictly as diarrhea but then turned into stomach pain, nausea, fatigue, as well as the diarrhea. My symptoms vary and recently I have been worked up for MALS. I’m the past I have had colonoscopy/endoscopy with biopsies, ruled out chrons, colitis, microcolitis, diverticulitis, etc. I have tried medications such as dicyclomine, Imodium, colestipol, protonix, amitryptiline, and lexapro (sorry if the spelling is incorrect). I also had my gall bladder out in March of this year for the liver pain and nausea without relief. I have tried diet modification and my pain/diarrhea worsens with exercise.
On a normal basis I have pain under my ribs on the right side (like liver pain) and down the right side of my stomach. I have had a few bouts where the pain has been severe and I was unable to eat. The last bout losing 9-10 lbs. I have in the last two months had two weeks of feeling almost normal with normal stool and no pain with eating. This is always short lived and the symptoms return. I had an ultrasound which showed stenosis of the celiac artery and just had a CT angio which showed mild celiac artery stenosis with a hooked shaped appearance of the celiac artery. I am awaiting speaking with the physician from here but want to know if anyone else has similar issues. Can I have the back and forth with my symptoms if it is MALS? And has anyone else had issues with severe diarrhea (6-10 Times a day). This is taking over my life and I am beyond frustrated.

REPLY
7 replies
blessedgma | @blessedgma | Nov 19, 2017
In reply to @blessedgma "I am relieved to have stumbled upon this connect site! I had laproscopic surgery 10 days..." + (show)
@blessedgma

I am relieved to have stumbled upon this connect site! I had laproscopic surgery 10 days ago to release the ligament and remove scar tissue from compressing the celiac artery. They also had to release pressure by cutting into my diaphragm. I am discouraged as the burning pain under my right side has returned since I stopped the post surgical pain meds. I go back this next week for an ultrasound to see if the Stent needs to be inserted. Knowing how common it is to feel nauseous still and have zero appetite, even pain with eating, makes me feel better. Kari,I'm so sorry that you're still dealing with all of this. Have you spoken with anyone who has had complete recovery from this syndrome?

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Thank you so much for your reply!
I was not given a choice of laproscopic vs open. The surgery was completed by a general surgeon with a vascular surgeon in the room. I will see the vascular surgeon on Wednesday as well.
What you said makes sense about possibly having a kink still, and hopefully fixing that will bring relief.
Reading a lot of the entries here, have been so helpful and encouraging, just not feeling alone.

REPLY
Kari Ulrich, Alumna Mentor | @kariulrich | Nov 19, 2017
In reply to @blessedgma "I am relieved to have stumbled upon this connect site! I had laproscopic surgery 10 days..." + (show)
@blessedgma

I am relieved to have stumbled upon this connect site! I had laproscopic surgery 10 days ago to release the ligament and remove scar tissue from compressing the celiac artery. They also had to release pressure by cutting into my diaphragm. I am discouraged as the burning pain under my right side has returned since I stopped the post surgical pain meds. I go back this next week for an ultrasound to see if the Stent needs to be inserted. Knowing how common it is to feel nauseous still and have zero appetite, even pain with eating, makes me feel better. Kari,I'm so sorry that you're still dealing with all of this. Have you spoken with anyone who has had complete recovery from this syndrome?

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@blessedgma Happy to have you here! I have heard of several people who have complete relief of MALS after laparoscopic and open surgery, so there is hope! I believe more people are relieved from symptoms than have a recurrence, however we do not hear back from them. I am wondering if your artery is still kinked from being compressed for so long, it will be interesting to hear what your velocities are on inspiration vs expiration! Did you have the option to have laparoscopic vs open? Just curious if a vascular surgeon or a general surgeon did your surgery.

REPLY
blessedgma | @blessedgma | Nov 19, 2017

I am relieved to have stumbled upon this connect site! I had laproscopic surgery 10 days ago to release the ligament and remove scar tissue from compressing the celiac artery. They also had to release pressure by cutting into my diaphragm. I am discouraged as the burning pain under my right side has returned since I stopped the post surgical pain meds. I go back this next week for an ultrasound to see if the Stent needs to be inserted. Knowing how common it is to feel nauseous still and have zero appetite, even pain with eating, makes me feel better. Kari,I'm so sorry that you're still dealing with all of this. Have you spoken with anyone who has had complete recovery from this syndrome?

REPLY
2 replies
cberry | @cberry | Nov 16, 2017

Thank you I joined that group as well. Thank you for that info, I'll look up that doctor and do some research.

REPLY
Kari Ulrich, Alumna Mentor | @kariulrich | Nov 15, 2017

@cberry There is a group on facebook called MALS PALS, they are terrific, my friend Robin is a moderator their. They keep a list of doctors that patients have seen for MALS. This was listed for Kansas: Dr. Lowry (works with GI – Dr. Molaos) Shawnee, Kansas. I have not heard of either of them personally, but that maybe a start? For me what has helped for the pain is to take tramadol before meals, however it considered addictive and doctors are reluctant to prescribe it.

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cberry | @cberry | Nov 15, 2017

I am in Kansas, my surgery was done at Salina Regional. Im not happy with the doctors here and desperately want someone to listen to me. I havr four kids and I am miserable everyday. I just want to feel better.

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