Do you get severe stomach pain after eating? Let's learn about this MALS! (Median Arcuate Ligament Syndrome)

Do you feel a sharp pain in your upper stomach right after you finish eating? No matter what you do, it doesn't go away? Does this pain bother you so much that you're afraid to eat? Are you frustrated that you've been to every doctor and tested, but still can't find a cause? This is truly a helpless experience. Today, we're talking about a rare condition that causes similar symptoms, but is not very well-known.

What exactly is MALS? Let's understand it simply.

To understand this, let's take a look at something else inside our bodies. Think about the main blood vessel that goes from our chest to our stomach, the aorta. This is like the main pipe that sends blood to all parts of our body.

A major branch of this artery is called the `Celiac Artery`. This supplies blood to important organs in our abdomen, such as the liver, stomach, and pancreas.

Now, above this `Celiac Artery`, there is a ligament called the `Median Arcuate Ligament`, which is like a small arch. Normally, blood flows smoothly between these two without any problems.

But in someone with MALS, this `Median Arcuate Ligament` is located a little lower. Then, what happens is, it compresses the `Celiac Artery` and the bundle of nerves that goes near it `(Celiac Plexus)`. Just like when someone steps on a water pipe, the water flow decreases, because of this compression, the amount of blood going to those organs decreases. That's when that terrible pain starts to come.

This is also called `Celiac Artery Compression Syndrome`.

What are the main symptoms of MALS disease?

The main and most obvious symptom of this disease is a severe pain in the upper abdomen after eating. This pain is so severe that some people are afraid to eat. They even try to avoid food for fear that "if I eat, the pain will come back."

Why do these MALS form?

Experts have not yet found a clear, specific reason for this, but there are several theories.

• Something that comes from birth: Some researchers say that some people are born with the `Median Arcuate Ligament` in the wrong place, a little lower.
• Other causes: There is another theory that this condition can occur as a complication of abdominal or back surgery, or after some kind of trauma to the abdomen.

Complications due to delayed diagnosis

This is one of the biggest challenges with MALS. The disease is very difficult to detect quickly. It can take months, even years.

• Mental problems: Chronic pain can lead to conditions like depression .
• Anxiety: When you can't find the cause of your illness despite multiple tests, it's very common to feel a great deal of worry and fear, wondering, "What's wrong with me?"

How does a doctor diagnose MALS?

Your doctor will first listen to your symptoms and examine you. But as we discussed earlier, there are many other common conditions that can cause upper abdominal pain, such as gastritis, appendicitis, and gallstones.

Therefore, before suspecting MALS, the first thing the doctor will do is check if you have any of these common diseases and make sure that you don't have them one by one. This requires various tests.

What are the treatments for MALS?

Once you are diagnosed with MALS, there are treatments that can provide you with relief.

1. Surgery (Median Arcuate Ligament Release):

The main and most effective treatment for this is surgery. Here, the surgeon cuts and releases the `Median Arcuate Ligament` that is holding the blood vessel in place. This relieves the pressure on the blood vessel and nerves, and blood flow is restored. This helps to almost completely eliminate the pain.

2. Celiac Plexus Block:

In some cases, there is a method of injecting a ``Celiac Plexus`` into the compressed nerve bundle to provide temporary relief from the pain. This can control the pain.

The medical team that will help you with this

Because MALS is a condition that affects both physically and mentally, specialists from various fields work together as a team to help you.

• Gastroenterologists: They primarily work on diagnosing diseases.
• Surgeons (General/Vascular Surgeons): They perform the surgery.
• Pain management specialists: Help manage pain.
• Psychologists: Help deal with stress, anxiety, and depression caused by the disease.
• Dietitians: Provide advice on healthy weight gain and proper nutrition after surgery and during weight loss.

What happens after treatment? Do I need to see a doctor again?

After surgery, symptoms often subside significantly, and you can live a normal life.

However, there is a chance that this condition will recur in rare cases. There is no specific way to prevent it. However, it is important to recognize the symptoms early if they recur. Therefore, it is wise to talk to your doctor and ask what the original symptoms were if the problem recurs.

The journey to diagnosis can be long and tiring. But when you finally find the cause and receive treatment, you will feel a great sense of relief. You will be able to enjoy food without fear again and live your life happily.