Median Arcuate Ligament Syndrome (MALS)

I went to the doctors for pain I have been having for years. I have constant pain in my abdominal area. I have several scans done and they believe I have MALS (arcuate ligament syndrome). It’s my understanding they could determine it through scans. The Dr. wants me to get a nerve block if it works he said I have MALS if it doesn’t work I have something else. My question is are there some cases where a nerve block is required to determine MALS?

Hi. These symptoms exactly match mine. I have had 8 years undiagnosed except for Small Intestinal Bacterial Overgrowth (SIBO). Can MALS cause SIBO does anyone know or have? I am going to the Scottsdale MAYO clinic next week. Is there anything I should ask them or tell them to help them diagnose this if it is the condition I'm struggling with? Haven't been able to eat for 2 months so living on elemental diet which can even cause pain. Lost a lot of weight. I usually have exacerbations like this that put me in bed with epigastric pain and what feels like overwhelming autonomic nervous system symptoms but usually they come right in days to maybe 2 weeks but never this long so know I'm getting worse and I need a diagnosis. SIBO is not a diagnosis - there is always an underlying cause and I have had most others, except for SMAS, excluded. Diet modification does nothing. Medication, other than pain killers taking the edge off it and lorazepam calming me down, otherwise do nothing. It is very waxing and waning in symptoms, night or day. Exercise, stress and eating anything are the triggers. Sounds just like MALS to me. Should I also ask the specialists there to test me for vascular and connective tissue disorders? Thanks so much, this is all new but hopeful finally

I have had 3 procedures for my MALS The first was a major open surgery. A little over a year later, they wanted to do a bypass but I was not healthy or strong enough so they put stents in celiac and SMA artery. I was rare since my sma was involved. Then I had a balloon in my celiac. It is now narrowing again. For me, this is going to be a life long thing. For many though, I have seen people have even laparoscopic surgery and eventually they are fine. These people usually have the compression and nerves taken care of . Every person is different. It is definitely possible to have one and done. It all depends on your situation. Honestly more often there are more than one surgery, but there are people with one and are fine.

I guess it goes without saying that most of the people who have had success are probably no longer on the blogs? I joined the Facebook group MALS Pals. It was interesting and helpful reading various stories But also left me with the feeling that no one procedure is ever completely successful in taking care of this condition?

@kariulrich, do you happen to know what the consensus is if you do not have treatment for this...will it get worse. I know that was not an option for you but wonder if you have heard in your years of treatment. Thanks.

@annief I wish I could be of more help in the recovery time is for robotic surgery, the one thing I can recommended is that no matter what type of surgery you have... you must take eating again very slow! It is wonderful to have less pain, and it is so easy to over do it! I also can relate to the pain you feel with sitting with your arms crossed... yes that is REAL!! Please know I am a chronic MALS patient, so I have had several surgeries... many people have one and are cured. For me, I have a difficult time due to other diagnosis on top of MALS, however I the good I get out of it is that I can help others who have similar symptoms or complications. So... back to the arms crossed, for me... when the pain is bad I cannot wear a bra... way too constricting, also with the weight loss you get to be a little more bony which causes pain with undergarments! Sorry men that are reading this.... but its true. Also, wearing a belt for me can be uncomfortable...which does not make a lot of sense since it is lower on the abdomen, however... it is still constricting. My one question to you is how will the surgeon determine if the artery has good blood flow after the release of the ligament? Did he explain? I am so excited that there are less invasive ways to treat this condition, so I look forward to hearing about your journey. For many of us, the longer the compression, the harder it is for that artery to go back to its normal shape. My surgery was open, and after the ligament was cut my artery was still kinked, verified by inter-operative ultrasound. I had a celiac bypass done, also it was discovered that the compression had resulted in increased velocities in my hepatic/splenic artery and a patch angioplasty was done to correct that. I was in my early 40's for my first surgery. I hope this helps! Please feel ask questions! Good to have you here.

Thanks for the quick response! I will definitely be straight forward. As to what you were saying about the autonomic nervous system that totally makes sense for the palpitations and shortness of breath. Do you also have a burning or warm feeling under the sternum? My pain comes and goes a lot too. It sucks that to see all these specialist it takes weeks to get in. I am so ready to be out of pain and being uncomfortable..