Median Arcuate Ligament Syndrome (MALS) is a rare but often misunderstood condition that affects the celiac artery and surrounding nerves. While some skeptics question its legitimacy, many patients and medical professionals recognize its impact. 

Here, we delve into five key insights to better understand MALS and dispel some of the myths surrounding it — as well as where to find the best MALS surgeon in Beverly Hills. 

Understanding MALS: What Is It?

Median Arcuate Ligament Syndrome — also known as Celiac Artery Compression Syndrome — occurs when the median arcuate ligament, a band of tissue that connects the diaphragm to the spine, compresses the celiac artery. This compression can reduce blood flow to the stomach, liver, and other organs, leading to a range of vascular compression symptoms. Patients often experience stomach pain, weight loss, and digestive issues like pain after eating. The condition's rarity and the overlap of its symptoms with other gastrointestinal disorders make it challenging to diagnose, leading some to question its existence.

1. Answers to The Most Common Questions About MALS 

There are several questions that people suffering from MALS tend to have, such as:

  • Can MALS cause dizziness? The answer is yes. MALS can cause dizziness, often due to reduced blood flow, leading to decreased oxygen delivery to tissues.
  • Can MALS cause neurological problems? MALS rarely causes neurological problems but can lead to symptoms like dizziness and fatigue, indirectly affecting neurological function.
  • Can MALS come and go? Yes, the symptoms of MALS can come and go — often fluctuating with physical activity and changes in body position.
  • Can MALS go away on its own? It is very unlikely that MALS will go away on its own. It almost always requires medical or surgical intervention for symptom relief.
  • Can MALS resolve on its own? MALS pain won’t resolve on its own — most cases of MALS will require treatment to alleviate symptoms.
  • Can an endoscopy show MALS? An endoscopy cannot show MALS directly but can help rule out other gastrointestinal conditions; imaging studies like ultrasounds or computed tomography angiography (CTA) are more definitive for diagnosing MALS.
  • Does MALS cause weight gain? MALS does not typically cause weight gain; it is more commonly associated with weight loss due to pain and difficulty eating.
  • Does MALS cause weight loss? Yes, MALS can cause weight loss as a result of chronic abdominal pain and reduced food intake.
  • Does MALS make you tired? Yes, MALS can make you tired, primarily due to chronic pain and the body's reduced ability to absorb nutrients effectively.
  • Does MALS make your back hurt? Yes, MALS can make your back hurt, as the pain can radiate from the abdomen to the back.
  • How do you detect MALS? MALS is detected through imaging studies such as Doppler ultrasound, CT angiography, or magnetic resonance angiography (MRA), which visualize the compression of the celiac artery.
  • How do you manage MALS? MALS treatment usually consists of surgical intervention to release the compression of the celiac artery, along with pain management and dietary modifications to alleviate symptoms. 

While the specific cause of MALS is largely unknown at this time, it is thought to be associated with the compression of the celiac artery due to inflammation, recent significant weight loss, or weakened muscles. 

2. Symptoms and Diagnosis: The Struggle for Recognition

Since the symptoms of MALS are often nonspecific, MALS can mimic other conditions like irritable bowel syndrome (IBS), Ehlers-Danlos Syndrome, or gastroparesis. This overlap can lead to misdiagnosis or delayed diagnosis, causing frustration for patients. Common symptoms include:

  • Severe, chronic abdominal pain, particularly after eating
  • Unintended weight loss
  • Nausea and vomiting
  • Diarrhea or constipation
  • Bloating

Diagnosing MALS involves a combination of patient history, physical examination, and imaging studies. Doppler ultrasound, CT angiography, and MRI can help visualize the celiac artery and identify any compression by the median arcuate ligament.

3. The Debate: Is MALS a Legitimate Condition?

The legitimacy of MALS has been a topic of debate within the medical community. Skeptics argue that because MALS is rare and its symptoms overlap with more common conditions, it might be overdiagnosed or even a misdiagnosis. However, advancements in imaging technology have allowed for more accurate identification of arterial compression, bolstering the argument for MALS as a genuine condition.

Moreover, patients who undergo surgical intervention often report significant relief from symptoms, further supporting the legitimacy of MALS.

4. Treatment Options: From Conservative to Surgical

Treatment for MALS can vary depending on the severity of symptoms and the degree of arterial compression. Conservative approaches may include dietary modifications, pain management, and medications to improve digestive function. However, these measures often provide only temporary relief.

For many patients, surgery for MALS offers the best chance for long-term symptom relief. The most common procedure is laparoscopic median arcuate ligament release, where the ligament is cut to relieve the compression on the celiac artery. In some cases, vascular reconstruction may be necessary to restore adequate blood flow. MALS surgery complications include a slight risk of bleeding and infection. MALS recovery after surgery is usually immediate, although recovery from the surgery itself may take a few weeks. 

5. Shedding Light on MALS

While the debate over the legitimacy of MALS continues, it's clear that this condition has a significant impact on those who suffer from it. Increased awareness, better diagnostic tools, and effective treatments are crucial in addressing the needs of MALS patients. By understanding the realities of MALS, we can move beyond the myths and offer hope and relief to those affected by this challenging condition.

Where to Find Relief from MALS: Dr. Danny Shouhed's Los Angeles Practice

If you're seeking relief from MALS, Dr. Danny Shouhed is the leading surgeon for MALS — he and his expert team are here to help! Dr. Shouhed is renowned for his expertise in diagnosing and treating MALS, with a deep understanding of the condition's complexities. His extensive experience and commitment to patient-centered care ensure that each individual receives a personalized treatment plan tailored to their specific needs.

At Dr. Shouhed's practice, you'll find a dedicated and compassionate staff who specialize in MALS. They are equipped with the latest diagnostic tools and surgical techniques to provide the highest level of care. From the initial consultation to post-treatment follow-up, Dr. Shouhed and his team are committed to supporting patients every step of the way, ensuring a comprehensive approach to managing and alleviating MALS symptoms.

Choosing Dr. Danny Shouhed's practice means entrusting your health to a leading physician who prioritizes patient well-being and strives for the best possible outcomes. With a focus on innovative treatment options and compassionate care, Dr. Shouhed and his team are here to help you find relief and improve your quality of life.

Are you ready to schedule a consultation with Dr. Danny Shouhed and take the first step toward effectively managing your MALS symptoms?