Clinicians often hear patients describe post-meal pain that "doesn’t seem serious," yet this symptom is one of the earliest hallmarks of Median Arcuate Ligament Syndrome (MALS).

MALS develops when a band of tissue near the diaphragm presses on the celiac artery and surrounding nerves, disrupting blood flow and triggering symptoms that can feel confusing or random. Because it’s uncommon and often mistaken for more familiar conditions like gastritis or gallbladder issues, many people spend months or even years searching for answers. 

Read on to learn about the early warning signs of MALS, whether you’re at risk for developing it, and where to find the best MALS treatment specialist in Los Angeles for an accurate diagnosis and fast relief. 

Early Signs and Symptoms of Median Arcuate Ligament Syndrome

One of the most common questions people ask us is, “How can I tell if I have MALS?” Noticing small changes in how your body reacts to meals or activity is often the first symptom. Finding a provider who can properly investigate these subtle changes is your best chance for getting an accurate diagnosis sooner rather than later. Top symptoms to watch for include: 

1. Upper Abdominal Pain After Eating, Especially After Weight Loss Surgery

Many people with MALS describe a deep, aching pressure right under the ribs that shows up shortly after they eat, especially after bigger meals. It can feel like the stomach is struggling to keep up, even when the food isn’t heavy or greasy. Some people notice that the pain eases a bit when they lean forward or stand at the counter while eating, as if changing their posture creates a little more breathing room inside. 

Several medical conditions can cause stomach discomfort, but pain that consistently appears after meals and eases with body position can be an early clue that the celiac artery or nearby nerves are being compressed. When this kind of pain shows up alongside other changes like gradual weight loss or a growing fear of mealtimes, known as sitophobia, it’s worth getting checked out by the best MALS specialist in Los Angeles.

2. Unintended Weight Loss

Many people with MALS notice an unintentional weight loss long before they realize how much their eating habits have changed. As meals start to feel like something to get through rather than enjoy, you might start nibbling at a few bites before pushing the rest away, hoping to avoid the tight, burning pressure that happens if you eat more. Losing weight because eating hurts and skipping meals is easier than dealing with the pain is a sign that you’re not dealing with common gastritis and need the attention of a MALS specialist. 

3. Frequent Gastrointestinal Symptoms and Exercise Intolerance

People with MALS often describe feeling nauseated or unusually full, even if they only ate a small portion. Another common symptom is feeling like your stomach is tight or swollen, making it hard to breathe comfortably. Some people also experience loose stools or constipation, creating a cycle that feels unpredictable and frustrating. Fatigue after eating, almost like the body is working overtime just to digest, is another common symptom of MALS. Exercise can worsen discomfort because the increased blood flow can make upper abdominal pressure worse. 

These symptoms can look a lot like IBS, gastroparesis, or even signs of an eating disorder, which leads many people down the wrong path when searching for a diagnosis. The bottom line is, if you’re experiencing nausea, bloating, bowel changes, post-meal fatigue, and activity-related pain, it’s important to get a thorough evaluation from a gastrointestinal physician. 

Who is at Risk for Developing MALS?

MALS tends to show up more often in young adults, especially women in their 20s to 40s. However, anyone who recently lost weight without trying might notice that their symptoms worsen as the layer of protective fat around the artery thins. Others may have a naturally low-lying ligament that presses more easily on the celiac artery, even though nothing on the outside seems different. 

Because MALS is usually diagnosed only after other explanations have been ruled out, many people spend months being tested for gallbladder issues, ulcers, or IBS before anyone considers compression as the cause. When pain after eating, frequent stomach upset, weight changes, and a pattern of avoiding food all appear together, you may want to see a MALS specialist instead of waiting for yet another round of inconclusive tests from a primary care physician.

Where to Find the Best MALS Specialist in Los Angeles for an Accurate Diagnosis and Effective Treatment

Many of our patients say the first moment they feel real hope is when they sit down with Dr. Danny Shouhed and finally feel understood. In our Beverly Hills office, we see how Dr. Shouhed’s calm, thoughtful way of explaining complex abdominal conditions helps people make sense of symptoms they’ve carried for months or years. 

As a board-certified minimally invasive and robotic surgeon, Dr. Shouhed brings a level of precision and depth that comes from years of focused work in foregut, GI, and metabolic surgery. His background, including graduating summa cum laude at UCLA to completing advanced training at Cedars-Sinai and Mount Sinai, shapes the way we approach MALS treatment with precision and accuracy. 

Patients across Los Angeles, as well as those who travel from across the country, choose our practice because Dr. Shouhed blends his highly technical skills with a genuine curiosity about each person’s story and a dedication to providing the most effective treatments.

Ready to finally get an accurate diagnosis and effective treatment from the best MALS doctor in Los Angeles?