Median Arcuate Ligament Syndrome (MALS)

[Eivissa]

Good morning all,

Has anyone on here been diagnosed with MALS?

[Blearyeyed]

No , but I have heard of other people that suffered with non diet related gastric problems and IBS because of it . They also found it very painful to do more intensive exercise and cardio because it hurt if they had to breath in too heavily or quickly.

I remember , vaguely , one commenting that they needed to drink more water , take smaller mouthfuls of food and eat very little portion meals through the day to stop the stomach pushing up against the tight thorax.

Have you been offered any treatment , breathing exercises or physio for it?

So sorry to hear about your diagnosis , but hopefully you will be able to get some answers now about how to make it easier , take care , Bee

[Eivissa in reply to Blearyeyed]

Hi Bee,

Thank you for responding. I have not been diagnosed as yet but I get terrible pain after food and with exercise. I am now on Tramadol whilst waiting to see a Urologist to check my kidneys but this pain is intense! I have only just discovered MALS and wondered if it might be a possibility 🤔

[Blearyeyed in reply to Eivissa]

Right , ok, it's not looked for very often as it is not the most common cause for the symptoms you are experiencing.They do need to rule out other more common gastric , bowel and bladder causes first .

There are other more common muscle related issues that effect the use of your chest and exercise as well.

Stomach acid and acid reflux can cause pain as intense as that after meals and during exercise.

Is the pain more in your back and kidney area or your stomach?

Pulled chest and rib muscles from overexertion can cause these pains too , is there a possibility that you could have overstretched doing some exercise.

Kidney or liver infections can also cause similar symptoms but can usually be treated quite quickly with antibiotics.

I'd suggest you go back to the GP and discuss having more blood tests for things like coeliac , Crohn's and diverticulitis first if they haven't already done them.

Often the next step they take is to do an x-ray of the chest if you feel that's where you get the most pain, you could request that. I assume they had already done your kidney and liver function tests before referring you to urology , but if not those blood tests are a good start.

If the pain continues , ask to be referred to ENT or Gastroenterology. They do more tests including cameras down the throat , and ultrasound on the abdomen , liver etc. You can request for them to have a good look at your diaphragm then if you feel you are really struggling to move your ribcage , or you have hammer on anvil like pain and spasms specifically around the liver area and top of the stomach.

The urologist may choose , or you can be asked to refer you to another Department if they don't find anything urology related .

In the meantime , try keeping a food and exercise diary , and marking down which meals or activities give you the most pain ( and how long after doing it ) . This is really valuable when you go to an appointment because it can help you explain what's happening , and that lets the doctor narrow down what the cause might be.

Not down any more unusual symptoms and pain and where it was too.

Your diary will also help you to make some diet and exercise changes which can help reduce your symptoms until the doctor makes a diagnosis.

Drinking more water , and eating 5 smaller , lighter portions of food a day , rather than three big meals will start to help.

Try and reduce the saturated fat , processed food , red meat , coffee , alcohol , spicy foods and sugar as they can really increase pain after meals with stomach problems.

Take care and try to relax and pace yourself , worry does make these pains feel worse too , Bee

[Eivissa]

Thank you Bee, I should have stated that this has been going on for years now and all the obvious has been ruled out. Gastro couldn't help and just referred me on to pain management. Bloods show consistently high levels of Creatinine and high electrolytes but scans have come back clear. I have tried lots of medications, numerous diets and keeping a food diary but I get pain with everything. Drs and specialists have been left scratching their heads so I'm now researching the less common syndromes that may not have been considered. Fingers crossed that Urology may be able to shed some light 🤞.Thank you so much for your knowledge and concern, very much appreciated 😊

[Boxroad]

Don’t know what that is, I struggle with all the abbreviation’s lol