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Median Arcuate Ligament Syndrome City Name, ST

Median Arcuate Ligament Syndrome (MALS) Treatment

The median arcuate ligament curves around the aorta, connecting the diaphragm to the spine. Between the median arcuate ligament and the aorta is the celiac plexus, a group of nerves that affect several of the organs in the abdomen. Median arcuate ligament syndrome occurs when the ligament presses down on the nerves in the celiac plexus, causing pain and other symptoms. Danny Shouhed, M.D. is a board certified gastrointestinal surgeon that offers median arcuate ligament syndrome (MALS) treatment through his practice in Los Angeles and Santa Monica.

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Gastroparesis is a disorder of the stomach muscles or the nerves that cause the muscles to stop working. Gastroparesis is caused by a slow transit of food through the stomach and into the intestine. This disorder may result in paralysis of the small intestine and colon. Gastroparesis can inhibit the emptying of the stomach, preventing proper digestion.


Post orthostatic tachycardia syndrome is a form of dysautonomia. This is a disorder of the autonomic nervous system. This branch of the nervous system regulates heart rate, blood pressure, sweating, and body temperature. The key characteristic of POTS is an exaggerated increase in heart rate upon standing and is relieved by sitting or lying down. POTS displays dizziness or lightheadedness by improper regulation of blood pressure.

Connective Tissue Disorders

Connective tissue disorder affects the parts of the body that connect the structures of the body. Connective tissues are made up of two protein-rich tissues that support organs which are collagen and elastin. Many proteins have collagen as their building block, including collagen found in tendons, ligaments, skin, cartilage, bone, and blood vessels. Elastin is established in the ligaments and skin. Other organ systems affected are the heart, lungs, kidneys, and gastrointestinal tract. This disorder occurs when these connective tissues become inflamed, thus damaging the proteins and surrounding areas of the body.

Symptoms of MALS

Median arcuate ligament syndrome, or MALS, is a rare condition and the exact cause is not known. It often affects young women who are thin, which can be a symptom of their condition. The pressure on the celiac nerves can impact the associated organs. MALS can cause pain, especially when eating, which can result in patients with this condition to eat less. Some of the accompanying symptoms to abdominal pain include:

  • Vomiting
  • Nausea
  • Weight loss (usually more than 20 lbs)
  • Sitophobia (fear of eating)

The diagnosis of MALS can require a battery of tests and imaging to rule out other more common causes of abdominal pain and gastrointestinal issues. Once diagnosed, there are a few MALS treatment options available. The least invasive option is celiac plexus nerve block injection. This can reduce pain in the abdomen by reducing inflammation that can put pressure on the nerves, but repeated injections are usually necessary. Another treatment option is a minimally-invasive laparoscopic surgery that can relieve the pressure of the median arcuate ligament on the celiac plexus nerves.

If you have symptoms of median arcuate ligament syndrome (MALS), treatment is available through Danny Shouhed, M.D. Contact our office in Los Angeles to schedule your consultation with Dr. Shouhed to discuss diagnosis and treatment for MALS.

Median Arcuate Ligament Release

Beverly Hills Location

250 N. Robertson Blvd #106
Beverly Hills, CA 90211

Phone: (310) 890-5834

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Santa Monica Location

2121 Santa Monica Blvd
Santa Monica, CA 90404

Phone: (310) 904-6647

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