Median Arcuate Ligament Syndrome (MALS)

The pleasure was all mine @llwortman, you are a remarkable human being and such an inspiration. I am so happy our lives have crossed paths!

Never had MALS, just learning about it! It was great meeting you in person at Mayo Social Media event!

Has anyone with here with MALS experienced chest pain?

Here is an abstract that may help: http://www.sciencedirect.com/science/article/pii/S0890509608004226
(Management of Median Arcuate Ligament Syndrome: A New Paradigm
Andrew J. Duffy1, , , Lucian Panait2, Dan Eisenberg1, Robert L. Bell1, Kurt E. Roberts1, Bauer Sumpio1
1 Yale School of Medicine, New Haven, CT
2 Saint Mary's Hospital, Waterbury, CT
Available online 6 January 2009)

@bree11 Here is some very basic information about MALS: https://my.clevelandclinic.org/health/articles/median-arcuate-ligament-syndrome-mals
There are a few good papers on MALS geared toward the medical professional also, wish there more! There needs to be more awareness done on this condition. Have your doctors considered a GI motility study? For me most of my GI work up came back normal, I had a some motility issues but not significant enough to raise eyebrows. It is a long diagnostic road, but worth taking in the end. If the tests get too much, let the doctors know. Sometimes I needed to take a month off of testing just to get away from the hospital awhile. (With my doctor's permission). I was fortunate that my Mayo team really believed in shared decision making. The fact you found a doctor that is willing to look further into MALS is priceless! That says a lot, and you may find that you may be guiding your care and teaching more than you expected. Don't be afraid to tell him what you have learned.

Hi Kari,
I have had endoscopy and colonoscopy, CT's, ultrasounds, x-rays and lots of blood work, with no results aside from the narrowing seen on the celiac trunk. I will be going in to see a GI in the next couple of weeks and she wants to do another endoscopy and colonoscopy. I do understand what you are saying about the ischemia and am on blood thinners and will remain on them indefinitely as clotting runs in my family and this was my second diagnosed unprovoked DVT, first PE. I am working at being my own advocate and just recently found a new doctor, though he was unaware of MALS and is looking into it further for me.

@bree11 I do not believe a blood clot can cause MALS, but they could cause identical symptoms, if it happened in an artery involving your abdomen. Does that make sense? If you have a clot in the brain, you will have symptoms depending on where the clot is. If you have ischemia (decreased oxygen flow) in your tummy you can have severe abdominal pain. I believe your symptoms warrant further work up. I have had severe abdominal pain from my Mals, due to ischemia. ( I hope this is making sense to you) Have you had any GI work up? What other testing have you had done? Please remember you are your best advocate.

@coffeelatte very nice to meet you! I think every MALS patient is a bit unique in their pain and the exact location. I was just speaking with another MALS/FMD patient tonight and we discussed how there is the pain and then there is also GI problems that go along with the MALS that seem to linger on for many MALS patients after the surgery. Many of us report malabsorption issues to our physicians both before and sometimes after the surgery. For me the surgery stopped the severe pain that I experienced after eating and during exercise. I still deal with GI motility issues, however they have been under control with the use of fiber and probiotics. Gas and bloating before surgery was severe and after surgery are manageable. Surgery is a big commitment and the recovery time is long, depending on the type of surgery. There is not a "text book" case for MALS... so it does not surprise me your symptoms maybe different. Here are some questions to think about: Are your symptoms affecting your quality of life? Have you avoided situations because of your symptoms? Have you and your physician tried every possible treatment? It is very overwhelming, but you are not alone in this! Learn everything you can and make an educated decision either way. How is your family taking this? Do you have support?

Hi Kari. I am 59 years old and was just diagnosed with MALS on Monday (two days ago) after having many tests run over the past year by my PCP and my GI doctor. After a year and no diagnosis, I went to Ohio to get second opinion at the Cleveland Clinic where it was confirmed with a Doppler Ultrasound and a CT Angiography after the doctor heard a bruit in my abdomen. I have severe stenosis of the celiac artery (368). However, the surprising thing is, I do not have the type of pain the vascular surgeon typically sees with MALS patients. I have had some pain, on and off, for the past four years under my right rib, but it is mild. For me, the symptoms that make me miserable are: gas pain, bloating and slight nausea. I also have malabsorption and have lost about 10 pounds due to getting full so quickly. I was wondering if you or anyone else on this board have gas or indigestion as a symptom of MALS? I am so scared to do the surgery, it is all very overwhelming right now. Thanks

I have not been diagnosed with MALS as of yet though my CT scan shows narrowing of the celiac trunk.
In late October I was diagnosed with a DVT in my lower calf, a week later I was diagnosed with a PE. The following week I went in with signs of a stroke, the doctor sent me home with no testing after I told him I did not want morphine. Shortly after this I developed severe abdominal pain. The pain is chronic, though it goes from dull moderate to severe, worsened by eating, even the smallest amount. Since mid November I have lost just over 23 pounds. My questions are, has anyone else had the same kind of issues? Can a blood clot or stroke cause MALS?