Management of Gastrointestinal Symptoms in Dysautonomia - Laura Pace, MD, PhD

A video of a presentation at the 2018 Dysautonomia International Convention. Dr. Pace discusses MALS as a neurogenic issue, general GI issues in POTS patients, and more. 

Celiac Axis Compression Syndrome: A Syndrome of Delayed Diagnosis? - Gastroenterology & Hepatology

For many patients with MALS, the journey to diagnosis is filled with many obstacles–some are even viewed as a drug seekers in their local hospitals. This article addresses the theory that the pain of MALS can be attributed to the involvement of the irritation of the celiac ganglion nerves, which should be addressed during surgery.

Open and Laparoscopic Treatment of Median Arcuate Ligament Syndrome

In the world of modern medicine, MALS is a fairly new diagnosis. It was only 100 years ago that radiographic evidence of celiac artery compression was first described by Lipschutz in 1917. However, it wasn’t until 1964 that Harjola described clinical symptoms associated with celiac artery compression, and Dunbar described the first clinical series detailing surgical outcomes in 1965.


This article looks back at medical reports, specifically those written in the English language, from 1963-2012. It covers 400 surgeries taken from various case studies and includes both open and lap procedures.


MALS is still new ground in the medical community, and many doctors are unaware that it even exists. Surgeons are continuously improving treatment options to help patients return to a life free of debilitating epigastric pain.

Median Arcuate Ligament Syndrome: Evaluation with CT Angiography

This article from 2005 does an excellent job explaining how MALS can be seen on a CT. However, in this article, under the section titled “Treatment,” you will read that MALS is a “controversial diagnosis” and some physicians do not see it as a true clinical entity. This is based on surgical results and the number of surgeries that are reported as unsuccessful. Anyone who has MALS and is seeking treatment needs to research the surgeon they are working with and ask how many MALS surgeries the surgeon has performed, what their success rate is, and how they define success. Successful surgical treatment that results in the elimination of MALS pain is possible.

Why Was This Woman Suffering From Terrible, Unrelenting Stomach Pain?

Sometimes, when you are chronically ill, your diagnosis and a knowledgable doctor are found in unusual ways. One patient and her family shared their story with the New York Times, and, since then, many people have read it and asked their own doctors if their unexplained epigastric pain could be due to median arcuate ligament syndrome. Awareness is the first step to finding a diagnosis, and we never know how many people our stories might help. 

Dear Universities: Please Remember Your Students with Rare Diseases

This article for the Mighty was written by a MALS patient and talks specifically about her experiences with MALS and POTS.