Median Arcuate Ligament Syndrome (MALS)

Has anyone had Mals surgery, and recovered from it, only to have it come back again?
Like is it possible for Mals to come back?

@hannat - I’m happy that you have a diagnosis! I also went years with abdominal pain of different intensities, thinking it was GERD or gallbladder problems. However, it got progressively worse and I was diagnosed and had surgery 6 years ago. They had to place a stent in the celiac artery after a few months since it was still compressed. Since then, I have been fine. Towards the end I had severe pain 1-2 hrs after a meal.
I preferred not to eat much each meal. I never lost weight either.
I was told that many people go through life with this without symptoms.
If you can manage the pain by the way you eat, I think you probably don’t have to have surgery.
However, it may be a good idea to get an opinion from a vascular surgeon.

@piapettersson - Welcome to Mayo Clinic Connect! There are quite a few members with MALS- even if it is a rare condition.
I’m Swedish too, living in US, but I have close family there. I know what you are up against with the healthcare system there.
You could check with major University Hospitals if there are surgeons familiar with MALS. Do you live close to any?
Most physicians and surgeons here are not familiar with the syndrome.
Can I help you with specific information?

I live in Sweden, and I feel that the health care do not take my symtoms seouriusly, and there is not a lot of information to find.

Thank you.

Hello @hannat and welcome to Mayo Clinic Connect. I can imagine that finally getting a diagnosis after all of those years was bittersweet. Sometimes not knowing why you feel a certain way is worse.

Members like @jayson and @astaingegerdm may be able to help share their experiences and information on who they saw for care to help support you.

Is finding a specialist on the top of your priority list now that you have been diagnosed?

Hi, I am a 46 year old female and have just been diagnosed with MALS. I have had abdominal pain since my teens and have always treated it with either omeprazole/PPIs and antacids. I have not experienced the weight loss described in the symptom list, have been around the same size my whole life give or take 15 - 20 lbs. I am able to exercise just fine and don't have significant abdominal pain as long as I limit my food intake. However, I do have episodes lasting a couple weeks or so where my stomach hurts no matter what.

I am confused by the treatment options for MALS. Since I have gone my whole life without the significant weight loss, I am wondering if I can continue as is and avoid surgery. Or will it eventually worsen and cause long term problems if I don't. I live in North Carolina and would love to see a Dr who specializes in the syndrome. Any recommendations?

Hi, I had Mals surgery in Jan. 2020. There’s an amazing group on Facebook called MALS Awareness. They guided me through symptoms, testing, general information and post surgery. I highly recommend them as support.

Hi, I have been diagnosed with MALS but there is not a lot of information to find. I was wondering if anyone have had problems with a burning backpain?

Good morning all. I am now past the 3 month mark and still having a rough go of it with my stomach. My endoscopy came back reporting reactive/chemical gastritis, moderate grade - likely from taking too much ibuprofen after surgery. It's been a very frustrating month because my morning stomach upset has returned despite taking Protonix. It's still relieved by Tums, but lately I can't fall back asleep. I worry a lot that either it will become "chronic" and never go away (because on this forum you'll find people who seem to have it permanently) or that it's MALS again. Last week I felt pain and a tender spot under my ribs, very close to where the MALS pain was, and it freaked me out pretty bad. I tried to get in to see a therapist but wouldn't you know it, they wouldn't take my insurance.

From a rational perspective, the stomach issue doesn't seem to be from MALS. It's very consistent with the symptom pattern of gastritis, i.e., empty stomach pain, food actually makes it feel better as long as it's not acidic. Why it's taking so long for my stomach to heal from NSAIDs, which I haven't taken in almost 2 months, is baffling and discouraging. As for the pain, it also seems to be muscular or diaphragm related. If I rub it, it gets better, and if I stretch out my right side it feels better. If I breathe with my diaphragm I feel it on inspiration, then it fades. Because this was my 2nd surgery I'm just full of doubt and fear that it will come back, but it's probably too soon to get another duplex ultrasound done, especially when the symptom pattern is inconsistent with MALS.

Basically I'm hoping I've just hit the 3rd month slump post surgery that many MALS patients talk about. I'm really hoping that when I get to month 4, things will be looking more positive for me.