Receiving a diagnosis of Median Arcuate Ligament Syndrome (MALS) can bring you both a sense of relief and a source of anxiety. As a rare and often misunderstood vascular compression syndrome, MALS is challenging to diagnose accurately. Even after diagnosis, navigating the complex landscape of MALS treatment options and finding a specialist with experience in managing MALS can get overwhelming. 

The rarity of this condition means that many healthcare providers may have limited familiarity with it — adding further complications for those searching for the best treatment. 

If you’ve found yourself with a MALS diagnosis, the most important thing to remember is that the first step towards getting the best care for your MALS is developing a thorough understanding of your condition and the various treatment options available to you.

Read on to learn about modern MALS treatment options and how to connect with the best MALS treatment specialist in Beverly Hills. 

The Road to Getting a MALS Diagnosis

MALS is a rare condition that occurs when the median arcuate ligament compresses the celiac artery, potentially causing a range of gastrointestinal and vascular symptoms. The road to a MALS diagnosis is often long and winding — with some patients enduring experiencing years of unexplained symptoms before receiving an accurate diagnosis. While anyone can develop MALS, it is more commonly seen in younger, thin women. The condition may also have components related to environmental and family history. 

Symptoms of MALS can vary widely but often include:

  • Chronic abdominal pain, especially after eating
  • Nausea and vomiting
  • Weight loss
  • Bloating
  • Irregular bowel movements, such as diarrhea or constipation
  • Abdominal bruit — a sound heard through a stethoscope 

Because of the non-specific nature of these symptoms, MALS is frequently misdiagnosed as other gastrointestinal disorders — leading to a delay in treatment. Gastrointestinal disorders that are similar to MALS include: 

  • Cholecystitis
  • Gallstones
  • Choledocholithiasis
  • Crohn's disease
  • Inflammatory bowel disease (IBD)
  • Irritable bowel syndrome (IBS)
  • Chronic constipation
  • Colitis
  • Celiac disease
  • Lactose intolerance 
  • Parasitic infection

Getting the right diagnosis typically involves a combination of clinical evaluation, imaging studies, and invasive procedures. Some of the most effective medical imaging to diagnose MALS include duplex ultrasound, CT angiography, or MR angiography to visualize the celiac artery and surrounding structures. 

In some cases, more invasive procedures like mesenteric angiography — a medical imaging that examines the blood vessels of the digestive system — may be necessary to confirm the diagnosis. Additionally, celiac plexus nerve blocks can temporarily relieve symptoms and help confirm a MALS diagnosis.

Understanding MALS Treatment Options

Since MALS is a rare and often misunderstood disorder, knowing how to proceed can be challenging. There are a few different ways to get treatment for MALS — each option has its benefits, and understanding them all can help you and your doctor choose the one that’s right for you: 

Minimally-Invasive Treatment for MALS 

A conservative approach to treating MALS focuses on lifestyle changes and medication-based symptom management. This may include dietary modifications, pain management techniques, and medications to address specific symptoms like nausea or abdominal pain. Additionally, some patients find relief through minimally invasive procedures such as celiac plexus nerve blocks, which can temporarily alleviate pain by interrupting nerve signals.

Surgical Treatment for MALS

For many patients, MALS surgery offers the most effective long-term solution. The primary surgical approach involves a laparoscopic or robotic-assisted release of the median arcuate ligament. This procedure aims to decompress the celiac artery and alleviate symptoms. In some cases, additional vascular reconstruction may be necessary to restore proper blood flow. 

Preparing for MALS Treatment and Recovery

If you and your MALS specialist decide that surgery is the best option for you, proper preparation is important to a successful outcome and smooth recovery. 

Before MALS surgery, speak to your doctor or surgeon in detail about the procedure — specifically about the type of procedure you’re having, what anesthesia you’ll get, and what to expect for post-operative pain management. You’ll also want to follow your surgeon's pre-operative instructions carefully, which may include dietary restrictions and medication adjustments. Properly preparing for MALS surgery can significantly impact your recovery.

Preparing your home for post-surgery recovery by arranging a comfortable resting area and stocking up on necessary supplies is also important. You should plan to have someone stay with you and help you with daily tasks for at least a couple of days, as you may have limited mobility. 

How to Connect with the Best MALS Specialist in Beverly Hills

Given the rarity of MALS, it is important and challenging to find a specialist with extensive experience treating this condition. MALS surgeons should have expertise in vascular or gastrointestinal disorders and have performed MALS procedures with a track record of successful outcomes. 

‍Dr. Danny Shouhed is established as the nation’s leader in diagnosing and managing MALS. His profound knowledge of the condition's intricacies allows him to navigate the complexities of treatment and work collaboratively with you to develop a personalized treatment plan. 

From the moment patients enter for their initial evaluation to post-treatment care, Dr. Shouhed and his team prioritize a supportive environment. Their commitment reflects a conservative approach to managing MALS, aimed at alleviating symptoms and enhancing the overall quality of life for those affected by this condition. 

Are you ready to work with a caring provider who offers the best MALS treatment in Los Angeles?