For people living with Median Arcuate Ligament Syndrome (MALS), abdominal pain and bloating after eating can lead to months or even years of searching for an explanation. MALS is a rare vascular compression syndrome that affects about two in every 100,000 people, and its symptoms frequently resemble more common digestive conditions, making diagnosis extremely challenging. 

Most people end up seeing multiple GI doctors and undergo extensive testing before MALS is ever even considered as a diagnosis. When the diagnosis finally comes into focus, another problem arises: finding a gastrointestinal doctor who actually knows how to treat the condition. Very few GI surgeons have the knowledge and experience treating complex vascular compression syndromes, so for most patients, effective treatment means traveling. Read on to learn why seeing the best MALS treatment doctor in the United States is the best way to achieve symptom relief and how to prepare for your MALS specialist referral journey. 

Why is MALS so Difficult to Diagnose?

One of the biggest challenges with diagnosing MALS is that MALS symptoms can look like many other digestive disorders, including: 

  • Pain in the upper abdomen after eating
  • Nausea
  • Bloating
  • Feeling full early
  • Unintended weight loss because eating becomes uncomfortable

These symptoms are also common in conditions such as acid reflux, gallbladder disease, ulcers, and irritable bowel syndrome. As a result, patients can end up spending months or years trying different medications, changing their diets, and undergoing testing before MALS is even considered as a diagnosis. 

How is MALS diagnosed? 

Diagnosing MALS also requires more than finding compression of the celiac artery on an imaging study. It takes a specialist who regularly evaluates vascular compression syndromes to understand how to put the pieces together and rule out other possible causes before recommending treatment. 

Why Should You Consider Seeing a MALS Specialist?

Most patients begin their journey with a primary care physician or a local gastroenterologist because digestive symptoms are usually the first concern. As testing continues, referrals to vascular surgeons, general surgeons, or other specialists tend to stack up. If symptoms continue despite treatment or imaging raises concern for MALS, a referral to the best MALS surgeon in the nation, who has extensive experience treating vascular compression syndromes, is the best next step.

What Does the Referral Process Look Like?

Traveling for a MALS evaluation begins well before you leave home. To save time and ensure you have the smoothest consultation possible, you should make sure to send all your medical records to your specialist. This includes any: 

  • Imaging studies
  • Procedure reports
  • A timeline of symptoms 
  • Notes from previous doctors and specialists you’ve seen for these symptoms

Reviewing this information in advance helps the best MALS treatment doctor in the United States understand which tests have already been completed and whether additional studies may be needed.

Additional testing, including a CT angiography, MR angiography, or duplex ultrasound during inhalation and exhalation, may be recommended based on the results of your previous testing. 

Why do Patients Travel Across The Country for MALS Treatment?

Experience matters when symptoms overlap with other disorders and treatment decisions require careful judgment. Because MALS is so uncommon, most unspecialized GI doctors only see a small number of cases each year and sometimes no cases at all. Because of this, patients often travel to receive care from a surgeon with extensive experience diagnosing and treating this complex condition. 

Another advantage of choosing a specialist is access to a multidisciplinary approach that brings together experts in vascular surgery, general surgery, gastroenterology, nutrition, and pain management. This collaboration provides a more complete picture of each patient's health and supports better treatment planning. 

What Should Patients Expect Before and After MALS Surgery?

If surgery is recommended, the treatment plan is designed around each patient's symptoms, imaging findings, and overall health. Primary procedure options include: 

Finding the Best MALS Treatment Specialist in the Nation

Choosing a surgeon with deep experience treating MALS makes all the difference when facing a rare and complex condition. As a board-certified surgeon, UCLA graduate, and fellowship-trained specialist from Mount Sinai Hospital, Dr. Danny Shouhed brings nationally recognized expertise in minimally invasive gastrointestinal surgery and complex vascular compression syndromes.

Ready to get effective relief from the best MALS doctor in the U.S.?