Dunbar Syndrome

Dunbar syndrome is a rare condition where a tight band of tissue under the diaphragm (the median arcuate ligament) presses on the celiac artery (a major artery that sends blood to the upper stomach-area organs) and can also press on nearby nerves called the celiac plexus. Many people can have some celiac artery “squeezing” on scans and still have no symptoms, so doctors usually diagnose Dunbar syndrome only when the pressure matches the person’s symptoms and other common causes of upper belly pain have been ruled out. The most typical story is upper middle (epigastric) pain after eating, sometimes with nausea, weight loss, and fear of eating because eating triggers pain; many experts think nerve pressure (not only low blood flow) is a big reason for pain. Clinical Cardiology Journal+3Cleveland Clinic+3National Organization for Rare Disorders+3

Dunbar syndrome (also called median arcuate ligament syndrome / MALS) happens when a tight band of tissue under the diaphragm presses on the celiac artery (a main blood vessel for upper-belly organs) and can also press on nearby celiac plexus nerves. This pressure can cause belly pain (often after eating), nausea, vomiting, and weight loss in some people. Mayo Clinic+2Cleveland Clinic+2

Another names

Dunbar syndrome is most commonly called Median Arcuate Ligament Syndrome (MALS). It is also called celiac artery compression syndrome or celiac axis compression syndrome, because the celiac artery (celiac axis) is the blood vessel that is being squeezed. National Organization for Rare Disorders+2Radiopaedia+2

Types

Type 1: Vascular-dominant (blood-flow) type. In this type, symptoms are thought to be related more to reduced blood flow through the celiac artery, especially when the body needs more blood after meals or during exercise. Clinical Cardiology Journal+2casereports.bmj.com+2

Type 2: Neurogenic-dominant (nerve-pain) type. In this type, symptoms are thought to come mostly from pressure/irritation of the celiac plexus nerves, which can create strong pain even when blood flow is not severely reduced. Mayo Clinic+2Cleveland Clinic+2

Type 3: Mixed type (both blood flow + nerves). Many patients likely have a mix: the artery is narrowed and the nerves are also irritated, so pain can be both “low-flow” and “nerve-pain” in nature. National Organization for Rare Disorders+2Clinical Cardiology Journal+2

Type 4: Anatomic compression without a syndrome (incidental finding). Some people have celiac artery compression on imaging but no typical symptoms; this is not usually called “the syndrome” unless symptoms and clinical findings fit. Clinical Cardiology Journal+2MDPI+2

Causes

1) Low-positioned median arcuate ligament. If the ligament sits lower than usual, it can press on the celiac artery more easily. PubMed Central+1

2) High origin of the celiac artery. If the celiac artery starts higher on the aorta than usual, it may sit closer to the ligament and be squeezed. PubMed Central+1

3) Tight or thick fibrous ligament tissue. A thicker or tighter band can create stronger outside pressure on the artery and nearby nerves. PubMed Central+1

4) Diaphragm anatomy variations (crura shape). The ligament is formed by diaphragm structures, so natural differences in diaphragm shape can change the amount of compression. PubMed+1

5) Compression becomes worse during breathing out (expiration). When you breathe out, the diaphragm moves upward, which can increase celiac artery squeezing in many patients. casereports.bmj.com+2Radiopaedia+2

6) “Hooked/J-shaped” narrowing at the artery start. The outside pressure can bend the artery in a characteristic curved shape that reflects mechanical compression. Radiopaedia+2Radiopaedia+2

7) Turbulent blood flow in the narrowed segment. When an artery is pinched, flow can become fast and turbulent, which is often seen on Doppler ultrasound during certain breathing phases. casereports.bmj.com+2Medultrason+2

8) Reduced blood supply during high demand (after meals). Digestion increases blood demand in the upper abdomen; if the artery is narrowed, the mismatch may trigger pain. Clinical Cardiology Journal+1

9) Reduced blood supply during high demand (exercise). Exercise can also increase abdominal blood demand and trigger pain in some people with MALS. Mayo Clinic+1

10) Pressure on the celiac plexus nerves. The nerve bundle around the celiac artery can be compressed, and many sources emphasize this nerve pressure as a key driver of symptoms. Mayo Clinic+2Cleveland Clinic+2

11) Abnormal nerve signaling / visceral hypersensitivity. Chronic irritation of nerves may make pain signals stronger than expected compared with the amount of artery narrowing. PubMed+2Clinical Cardiology Journal+2

12) Slender body habitus (less “padding”). MALS is often reported more in thinner individuals; less fat tissue may mean less cushioning around vessels and nerves. cdt.amegroups.org+2Cleveland Clinic+2

13) Rapid weight loss (possible contributor). If weight drops quickly, protective fat around vessels may decrease and symptoms may become more noticeable in some people. Cleveland Clinic+1

14) Young adult anatomy and flexibility (association). Many reports describe MALS more often in younger adults, suggesting anatomy and tissue mechanics may play a role. cdt.amegroups.org+1

15) Female predominance (association, not a proven direct cause). Many series report more females than males affected; this is an observation, not proof of a single cause. cdt.amegroups.org+1

16) Dynamic narrowing across the day (position + breathing). Because compression can change with posture and respiration, symptoms can vary and “come and go.” Mayo Clinic+2RACGP+2

17) Collateral blood vessels and altered flow patterns. Long-term narrowing can lead the body to reroute blood through alternative pathways, which can change symptoms and findings. Clinical Cardiology Journal+1

18) Delayed stomach emptying (functional effect). Pressure around the celiac area may be linked with slow stomach emptying in some patients, adding nausea/fullness to the symptom pattern. Mayo Clinic+2MDPI+2

19) Stress–pain cycle (symptom amplifier). Chronic pain can increase stress, and stress can increase pain sensitivity; this does not “cause” MALS anatomy, but it can worsen daily suffering. Mayo Clinic+1

20) Not fully understood overall cause. Major reviews note that the exact reason why some people with compression develop severe symptoms while others do not is still not completely clear. PubMed+2Clinical Cardiology Journal+2

Symptoms

1) Upper middle (epigastric) pain after eating. This is one of the most common symptoms; pain often starts after meals because digestion increases demand in the upper abdomen. Cleveland Clinic+2Mayo Clinic+2

2) Pain triggered by exercise. Some people feel upper belly pain during or after activity, likely because body demand changes during exercise. Mayo Clinic+1

3) Nausea. Nausea is commonly reported and can happen with or without vomiting. Mayo Clinic+2Cleveland Clinic+2

4) Vomiting. Vomiting may occur, especially when pain and nausea become intense. Mayo Clinic+2cdt.amegroups.org+2

5) Unintended weight loss. People may lose weight because eating causes pain, so they eat less. Mayo Clinic+2cdt.amegroups.org+2

6) Fear of eating (food avoidance). Some patients avoid meals because they expect pain after eating. Mayo Clinic+1

7) Bloating. A feeling of fullness, swelling, or “gas” can occur with this condition. Mayo Clinic+1

8) Diarrhea. Some patients report loose stools along with pain and nausea. Mayo Clinic+1

9) Early fullness (early satiety). People may feel full quickly, which can also contribute to weight loss. Clinical Cardiology Journal+2cdt.amegroups.org+2

10) Pain that improves with posture changes (leaning/standing). Some people notice pain feels better by leaning forward/backward or standing while eating. Mayo Clinic+1

11) Burning or aching upper belly tenderness. The upper belly area can feel sore or tender, especially during pain episodes. Clinical Cardiology Journal+1

12) Abdominal “whooshing” sound noticed by a clinician (bruit) plus symptoms. A bruit is not felt by the patient, but when present with typical symptoms it can be a clue. Mayo Clinic+2Mayo Clinic+2

13) Loss of appetite. Appetite can drop because eating is linked with pain and nausea. Clinical Cardiology Journal+1

14) Fatigue and low energy (from chronic pain and poor intake). Ongoing pain and eating less can lead to tiredness and weakness over time. Clinical Cardiology Journal+1

15) Symptoms that look like other stomach problems (dyspepsia-like pattern). Many sources warn that symptoms overlap with common GI diseases, which is why MALS is often a diagnosis of exclusion. Clinical Cardiology Journal+2Mayo Clinic+2

Diagnostic tests

Physical exam 

1) Detailed symptom history (timing with meals/exercise). The clinician asks when pain starts, what triggers it, and what makes it better. This matters because MALS often causes pain after meals or exercise, and diagnosis usually requires matching symptoms with imaging findings. Mayo Clinic+2Mayo Clinic+2

2) Listening for an abdominal bruit. The clinician uses a stethoscope to listen over the upper belly for a “whooshing” sound that can happen when a vessel is narrowed. It does not prove MALS alone, but it is a helpful clue in the right story. Mayo Clinic+2Mayo Clinic+2

3) Checking for upper belly (epigastric) tenderness. Gentle pressing on the upper belly can show localized tenderness, which supports that the pain is truly in that area (even though tenderness is not specific to MALS). Clinical Cardiology Journal+1

4) Weight trend and nutrition check. The clinician measures weight, BMI, and signs of poor intake, because unintended weight loss and food avoidance are common in symptomatic MALS. Mayo Clinic+2Clinical Cardiology Journal+2

Manual tests 

5) Posture-relief check (leaning forward/backward or standing). The clinician may ask the patient to describe or demonstrate whether posture changes reduce pain, because posture-related relief is reported in MALS. Mayo Clinic+1

6) Deep breathing maneuver (symptoms or bruit change with inhale/exhale). Since compression often changes with breathing (commonly worse on expiration), clinicians and sonographers pay attention to breathing phase during assessment. casereports.bmj.com+2RACGP+2

7) Symptom diary (meal and activity log). A diary is a practical “hands-on” tool: it helps document patterns (after meals, with exercise, posture relief) that can strengthen or weaken suspicion before advanced testing. Mayo Clinic+2Clinical Cardiology Journal+2

Lab and pathological tests 

8) Complete blood count (CBC). A CBC checks red and white blood cells and can suggest infection, anemia, or other problems that may explain pain, weight loss, or weakness; Mayo Clinic lists CBC as part of the workup when evaluating MALS symptoms. Mayo Clinic+1

9) Basic blood chemistry / metabolic panel (liver, kidney, electrolytes). These blood tests help look for liver, pancreas, kidney, and general metabolic causes of abdominal pain; Mayo Clinic notes blood tests are used to check these organ systems during evaluation. Mayo Clinic+1

10) Pancreas enzymes (amylase and/or lipase). These blood tests help evaluate pancreas irritation or pancreatitis-like problems, which can also cause upper abdominal pain and vomiting and must be considered in the differential. Testing.com+2University of Rochester Medical Center+2

11) Celiac disease serology (example: tTG-IgA). If chronic belly symptoms or weight loss are present, clinicians may screen for celiac disease because it can mimic many GI patterns; major guidelines describe serologic antibody testing as the main way to detect celiac disease before biopsy confirmation. ACG+2PubMed Central+2

12) H. pylori testing (breath test, stool antigen, or biopsy). Because dyspepsia and upper belly pain are common, guidelines often recommend H. pylori testing in appropriate patients, and endoscopy with biopsy can also evaluate it when endoscopy is done. cag-acg.org+2meridianbioscience.com+2

Electrodiagnostic / functional tests 

13) Gastric emptying study. This test measures how fast the stomach empties food; Mayo Clinic lists it because pressure in the celiac region may be linked with delayed emptying in some patients, and delayed emptying can also have other causes that must be ruled out. Mayo Clinic+2MDPI+2

14) Antroduodenal manometry (motility testing). In selected patients, specialized motility testing has been discussed in the setting of complex symptom patterns (like nausea/vomiting and suspected motility issues), though it is not a routine first test for MALS. jpeds.com+1

Imaging tests

15) Mesenteric duplex (Doppler) ultrasound with breathing protocol. This is a key screening test: it measures blood-flow speed in the celiac artery and looks for changes between inspiration and expiration that suggest dynamic compression. Mayo Clinic+2Radiopaedia+2

16) CT scan / CT angiography (CTA). CT (especially CTA) can show whether the celiac artery is narrowed and can show the typical “hooked” appearance on sagittal images. Mayo Clinic+2PubMed+2

17) MRI / MR angiography (MRA). MRI with angiography can show blood vessels and how blood moves through them, without using CT X-rays; Mayo Clinic lists MRA as a diagnostic option. Mayo Clinic+2MDPI+2

18) Catheter angiography / digital subtraction angiography (DSA), sometimes dynamic. This invasive imaging can directly show celiac artery narrowing and how it changes with respiration in some cases; it is often used when diagnosis remains uncertain or when planning treatment. RACGP+2Cleveland Clinic+2

19) Upper endoscopy (EGD) with biopsy if needed. Endoscopy looks inside the esophagus, stomach, and first small intestine; it is important because many other common diseases can mimic MALS symptoms, and Mayo Clinic lists EGD as part of the diagnostic workup. Mayo Clinic+2cag-acg.org+2

20) Celiac plexus block (diagnostic nerve block). A local anesthetic is injected near the celiac plexus nerves; short-term pain relief can support a “neurogenic” component and may help predict who might benefit from surgery. Mayo Clinic+2PubMed+2

Goals of treatment

The main goal is to remove the compression on the artery and nerves—this is why surgery (median arcuate ligament release) is the core “fix” when Dunbar syndrome is clearly diagnosed and symptoms are significant. Mayo Clinic+2Cleveland Clinic+2

Medicines and lifestyle steps do not remove the compression, but they may help control symptoms (pain, nausea, reflux, poor eating) while you are being evaluated, preparing for treatment, or recovering. Cleveland Clinic+1

Non-pharmacological treatments (therapies and other supports)

1. Small, frequent meals: Eat smaller portions more often to reduce after-meal pain. Purpose: fewer symptoms after eating. Mechanism: less stomach/intestinal “work” at one time. American College of Gastroenterology+1

2. Lower-fat meals: Choose lower-fat foods. Purpose: easier digestion. Mechanism: fat slows stomach emptying and can worsen “heavy/full” feelings. American College of Gastroenterology+1

3. Slow eating + thorough chewing: Purpose: reduce bloating and discomfort. Mechanism: less swallowed air and gentler digestion. American College of Gastroenterology

4. Food + symptom diary: Track meals, pain, nausea, and triggers. Purpose: find patterns. Mechanism: helps you and your doctor target avoidable triggers. Cleveland Clinic+1

5. Hydration plan (sip fluids across the day): Purpose: reduce dizziness/weakness if intake is low. Mechanism: supports blood volume and gut function. ESPen

6. Oral nutrition supplements (high-calorie shakes if weight is dropping): Purpose: prevent malnutrition. Mechanism: concentrated calories/protein in small volume. ESPen+1

7. Dietitian support: Purpose: safe weight gain/maintenance. Mechanism: personalized meal plan that fits symptoms. Cleveland Clinic+1

8. Avoid heavy exercise right after meals: Purpose: reduce post-meal pain. Mechanism: exercise can worsen symptoms for some people with MALS. Mayo Clinic

9. Posture tricks some people notice (leaning forward/back or standing while eating): Purpose: reduce pain in some cases. Mechanism: may slightly change pressure on the area. Mayo Clinic

10. Mindfulness / meditation: Purpose: lower pain stress and improve coping. Mechanism: changes how the brain processes pain signals. NCCIH+1

11. Cognitive behavioral therapy (CBT): Purpose: reduce pain-related fear and improve function. Mechanism: practical skills for thoughts, sleep, and stress that amplify pain. CDC+1

12. Gentle yoga / tai chi (if tolerated): Purpose: reduce stress and muscle tension. Mechanism: mind-body calming and steady movement. CDC

13. Heat therapy (warm pack on upper belly/back): Purpose: comfort. Mechanism: relaxes muscles and may calm pain signals. CDC

14. Breathing exercises: Purpose: reduce anxiety-pain loop. Mechanism: activates calming nervous-system pathways. NCCIH+1

15. Acupuncture (selected patients): Purpose: pain and nausea support. Mechanism: may affect nerve signaling and endorphins. CDC

16. Massage / manual therapy (gentle): Purpose: reduce muscle guarding from chronic pain. Mechanism: relaxes soft tissue and may reduce stress response. CDC

17. Sleep routine + sleep treatment: Purpose: better pain control and mood. Mechanism: poor sleep increases pain sensitivity. Cleveland Clinic+1

18. Pain-management specialist care: Purpose: safer, stepwise pain plan. Mechanism: uses multi-tool pain strategies (not only medicines). Cleveland Clinic+1

19. Celiac plexus block (diagnostic and/or temporary relief): Purpose: reduce pain and help confirm nerve involvement. Mechanism: numbs nerve signals from the celiac plexus. Cleveland Clinic+2Hopkins Medicine+2

20. Pre-op conditioning (gentle walking + nutrition plan): Purpose: stronger recovery if surgery is planned. Mechanism: improves stamina and nutrition before an operation. Cleveland Clinic+1

Drug treatments

Important safety note: These are general label-based examples, not personal medical advice. Doses depend on age, weight, kidneys/liver, and other medicines. Always follow a licensed clinician’s instructions. Mayo Clinic+1

1. Acetaminophen (Tylenol) — Class: analgesic/antipyretic. Typical adult dose: label-guided; avoid combining multiple acetaminophen products. Purpose: mild pain. Mechanism: central pain control. Side effects: liver injury risk with overdose. FDA Access Data

2. Ibuprofen (Motrin) — Class: NSAID. Typical adult dose: per label/clinician. Purpose: inflammatory pain. Mechanism: COX inhibition lowers prostaglandins. Side effects: stomach bleeding, kidney risk, BP effects. FDA Access Data

3. Naproxen sodium (Aleve) — Class: NSAID. Typical adult dose: per label. Purpose: longer-acting pain relief. Mechanism: COX inhibition. Side effects: GI bleeding/ulcer risk, kidney risk. FDA Access Data

4. Ketorolac (Toradol) — Class: NSAID (strong, short-term). Typical adult limit: short duration only (label highlights short-term use). Purpose: severe pain (often acute). Mechanism: strong prostaglandin blocking. Side effects: higher GI/kidney/bleeding risk. FDA Access Data+1

5. Tramadol — Class: opioid-like analgesic. Typical adult dosing: per label/clinician with careful titration. Purpose: moderate pain when other options fail. Mechanism: opioid receptor activity + neurotransmitter effects. Side effects: sedation, dependence, breathing risk. FDA Access Data

6. Oxycodone (example: OxyContin label) — Class: opioid analgesic. Typical dosing: strictly clinician-guided; extended-release is for selected patients. Purpose: severe pain. Mechanism: opioid receptor agonist. Side effects: breathing suppression, dependence, constipation. FDA Access Data

7. Morphine sulfate (injection label example) — Class: opioid agonist. Use/timing: typically monitored settings for severe pain. Purpose: strong pain control. Mechanism: opioid receptor agonist. Side effects: breathing suppression, low BP, dependence. FDA Access Data

8. Fentanyl transdermal patch — Class: opioid agonist (long-acting). Use: only for opioid-tolerant patients under specialist care. Purpose: persistent severe pain. Mechanism: opioid receptor agonist. Side effects: overdose risk if misused, dangerous breathing suppression. FDA Access Data

9. Lidocaine patch 5% (Lidoderm) — Class: local anesthetic. Timing: applied to skin per label limits. Purpose: localized pain support. Mechanism: blocks sodium channels in nerves. Side effects: skin irritation, numbness. FDA Access Data

10. Gabapentin (Neurontin) — Class: anticonvulsant/neuropathic pain agent. Timing: usually daily in divided doses with titration. Purpose: nerve-type pain. Mechanism: reduces excitatory nerve signaling. Side effects: sleepiness, dizziness. FDA Access Data

11. Pregabalin (Lyrica) — Class: neuropathic pain agent. Timing: daily; dose adjusted for kidneys. Purpose: nerve pain and pain sensitivity. Mechanism: calms overactive nerve signaling. Side effects: dizziness, swelling, sleepiness. FDA Access Data

12. Duloxetine (Cymbalta) — Class: SNRI. Timing: daily. Purpose: chronic pain modulation and anxiety/depression that can travel with chronic pain. Mechanism: increases serotonin/norepinephrine signaling. Side effects: nausea, BP changes, serotonin-syndrome risk with interactions. FDA Access Data+1

13. Amitriptyline — Class: tricyclic antidepressant. Timing: often nightly (doctor-directed). Purpose: nerve pain and sleep support. Mechanism: changes neurotransmitters and pain pathways. Side effects: drowsiness, dry mouth; extra caution in teens/young people for serious mood effects. FDA Access Data

14. Ondansetron (Zofran) — Class: antiemetic (5-HT3 blocker). Timing: as needed or scheduled. Purpose: nausea/vomiting. Mechanism: blocks serotonin signals that trigger vomiting. Side effects: constipation, headache; QT-risk in some patients. FDA Access Data

15. Promethazine — Class: antihistamine/antiemetic. Timing: as prescribed. Purpose: nausea and motion-type vomiting. Mechanism: blocks histamine and other nausea pathways. Side effects: strong sleepiness; not for children under 2 per label. FDA Access Data

16. Metoclopramide (Reglan) — Class: pro-motility/antiemetic. Timing: often before meals and at bedtime (doctor-directed). Purpose: nausea and slow stomach emptying symptoms. Mechanism: improves gut movement and blocks dopamine triggers. Side effects: movement-related side effects; label warns against long use. FDA Access Data

17. Omeprazole (Prilosec) — Class: PPI acid reducer. Timing: daily for a planned course. Purpose: reflux/ulcer-type burning that may overlap. Mechanism: blocks acid pumps in the stomach. Side effects: diarrhea, headache; long-term risks if overused. FDA Access Data

18. Pantoprazole — Class: PPI. Timing: daily (oral/IV forms exist). Purpose: acid-related symptoms. Mechanism: reduces stomach acid secretion. Side effects: similar to other PPIs. FDA Access Data

19. Famotidine (Pepcid) — Class: H2 blocker. Timing: once or twice daily depending on plan. Purpose: heartburn/reflux support. Mechanism: blocks histamine-driven acid release. Side effects: headache; adjust in kidney disease. FDA Access Data

20. Dicyclomine (Bentyl) — Class: antispasmodic/anticholinergic. Timing: before meals as prescribed. Purpose: crampy spasm pain that can coexist with gut sensitivity. Mechanism: relaxes intestinal smooth muscle. Side effects: dry mouth, constipation, blurry vision. FDA Access Data

Dietary molecular supplements

1. Oral nutrition supplement shake (protein + calories): Dose: 1–2 servings/day if needed. Function: prevents weight loss. Mechanism: dense nutrition in small volume. ESPen+1

2. Omega-3 (EPA/DHA): Dose: label-based. Function: supports inflammation balance. Mechanism: changes inflammatory signaling fats. APIM

3. Vitamin D: Dose: based on blood level. Function: bone, muscle, immune balance. Mechanism: hormone-like vitamin that affects many genes. SCIRP

4. Vitamin B12: Dose: depends on deficiency. Function: nerves + blood cells. Mechanism: needed for DNA and myelin. Office of Dietary Supplements

5. Folate (folic acid): Dose: label/clinician-guided. Function: red blood cells + cell repair. Mechanism: supports DNA building blocks. NCCIH

6. Iron (only if low): Dose: lab-guided. Function: treats iron-deficiency anemia from poor intake. Mechanism: restores hemoglobin for oxygen delivery. NCCIH

7. Magnesium: Dose: label-based. Function: muscle/nerve function. Mechanism: supports energy enzymes and nerve stability. SCIRP

8. Zinc: Dose: label-based. Function: wound healing + immune enzymes. Mechanism: cofactor for many proteins. DigitalCommons@PCOM

9. Probiotics (selected strains): Dose: product-specific. Function: may help some people with bloating/irregular stools. Mechanism: shifts gut microbes and their signals. Office of Dietary Supplements

10. Coenzyme Q10 (CoQ10): Dose: label-based. Function: energy support in cells. Mechanism: helps mitochondrial energy transfer. Mayo Clinic

Immune / regenerative / stem-cell drug

1. “Stem cell injections for Dunbar syndrome”: There is no FDA-approved stem-cell product for treating Dunbar syndrome, and unapproved uses can be risky. Dose: no approved dose for this condition. U.S. Food and Drug Administration+1

2. “Exosome therapy for chronic abdominal pain”: These are regulated biologic products; if someone offers them outside proper approval/trials, be cautious. Dose: no approved dose for MALS. U.S. Food and Drug Administration+1

3. “Regenerative shots that ‘repair the celiac artery’ ”: MALS is mainly a compression problem, so the proven fix is decompression surgery when appropriate. Dose: no approved regenerative drug for this. Mayo Clinic+1

4. “Immune booster drips”: If a clinic promises to “boost immunity” to cure MALS, treat that as a red flag—MALS is not an immune disease. Dose: not evidence-based for this purpose. U.S. Food and Drug Administration+1

5. “Peptide stacks for regeneration”: If marketed as treatment without FDA approval, this can be unsafe and illegal. Dose: no approved dosing for MALS. U.S. Food and Drug Administration+1

6. “Pay-to-play stem cell clinic programs”: FDA warns consumers to be careful about unapproved regenerative products offered outside proper trials. Dose: no approved dosing for MALS. U.S. Food and Drug Administration+1

Procedures / surgeries (what they are and why done)

1. Median arcuate ligament release (open / laparoscopic / robotic): Why: cuts/releases the ligament so it stops squeezing the celiac artery and nearby nerves; often the main treatment when diagnosis is solid. Mayo Clinic+2Cleveland Clinic+2

2. Celiac plexus block (procedure, not surgery): Why: may reduce pain temporarily and can help confirm nerve involvement during evaluation. Cleveland Clinic+1

3. Celiac ganglion / nerve tissue removal (selected cases): Why: if nerve compression is a major driver of pain, surgeons may address nerve tissue during decompression in some patients. Cleveland Clinic+1

4. Vascular repair / reconstruction (selected cases): Why: if the artery remains narrowed even after release, vascular surgeons may repair the vessel. Hopkins Medicine+1

5. Endovascular stent (carefully selected situations): Why: sometimes used to keep blood flow open, usually after decompression when narrowing persists; not the usual first step by itself. Hopkins Medicine+1

Prevention and flare-reduction tips

1. You usually can’t “prevent” MALS anatomy, but you can reduce symptom flares by planning meals and stress. Mayo Clinic+1

2. Avoid very large meals. American College of Gastroenterology

3. Avoid high-fat heavy meals. American College of Gastroenterology

4. Don’t skip nutrition for days—use shakes/soft foods to protect weight. ESPen

5. Limit trigger drinks (carbonated, excess caffeine) if they worsen symptoms. American College of Gastroenterology

6. Manage stress daily (mindfulness/CBT skills). NCCIH+1

7. Use a safe pain plan (prefer non-opioid approaches when possible). CDC

8. Keep follow-ups—MALS can take time to confirm and treat correctly. Cleveland Clinic+1

9. Avoid random “regenerative cures” online. U.S. Food and Drug Administration+1

10. After surgery, follow recovery instructions (diet progression, activity limits). Cleveland Clinic+1

When to see doctors urgently

Seek urgent care if you have severe belly pain, vomiting that won’t stop, blood in stool, fever, yellow skin/eyes, fainting, or chest-type pain symptoms—these can be signs of serious problems that are not “just MALS.” Mayo Clinic

What to eat and what to avoid

1. Eat: small meals, soft foods when flaring; Avoid: huge meals. American College of Gastroenterology

2. Eat: low-fat proteins; Avoid: very greasy/fried foods. American College of Gastroenterology

3. Eat: cooked vegetables if raw bloats you; Avoid: gas-trigger foods if they worsen symptoms. AAFP

4. Eat: rice/oats/bananas/toast during nausea; Avoid: spicy foods if they trigger burning. AAFP

5. Eat: soups and smoothies; Avoid: carbonated drinks if they bloat you. American College of Gastroenterology

6. Eat: hydration (water, ORS if needed); Avoid: dehydration. ESPen

7. Eat: nutrition shakes if weight loss is happening; Avoid: long fasting. ESPen

8. Eat: slow, mindful eating; Avoid: rushing meals. American College of Gastroenterology

9. Eat: moderate fiber as tolerated; Avoid: sudden big fiber jumps during flares. AAFP

10. Eat: foods you tolerate consistently; Avoid: “experimenting” with many new foods during bad weeks. Cleveland Clinic+1

FAQs

1. Is Dunbar syndrome the same as MALS? Yes—Dunbar syndrome is a common alternate name. Mayo Clinic

2. Is it caused by stress? No, it is a physical compression problem, but stress can worsen pain experience. Mayo Clinic+1

3. Does everyone with celiac artery compression have symptoms? No—compression can exist without symptoms. Mayo Clinic

4. Why does pain often happen after eating? Eating increases digestive activity; compression/nerve irritation may trigger pain. Mayo Clinic+1

5. Is weight loss common? It can happen, often because eating causes pain. Mayo Clinic+1

6. What is the main treatment when confirmed? Surgical release to remove the pressure. Mayo Clinic+1

7. Can medicines cure it? No medicine removes the compression; medicines mainly help symptoms. Cleveland Clinic+1

8. What tests are often used? Imaging like CT/MRI/angiography and duplex ultrasound after other causes are ruled out. Cleveland Clinic+1

9. What is a celiac plexus block? An injection that temporarily blocks pain signals from the celiac plexus. Cleveland Clinic+1

10. Is stenting always needed? Not usually; it may be considered in selected cases, often after decompression. Hopkins Medicine+1

11. Can symptoms return after surgery? It can happen; follow-up matters. Cleveland Clinic+1

12. Is it seen in children/teens? Yes, it can occur even in children. Mayo Clinic+1

13. What should I do if eating hurts? Use small, low-fat meals and talk to a clinician—don’t accept ongoing weight loss as “normal.” American College of Gastroenterology+1

14. Are “stem cell cures” real for MALS? No FDA-approved stem-cell therapy exists for this condition. U.S. Food and Drug Administration+1

15. Which doctor treats it? Often a team: gastroenterology, vascular/general surgery, pain specialists, and dietitians. Cleveland Clinic+1

Disclaimer: Each person’s journey is unique, treatment plan, life style, food habit, hormonal condition, immune system, chronic disease condition, geological location, weather and previous medical  history is also unique. So always seek the best advice from a qualified medical professional or health care provider before trying any treatments to ensure to find out the best plan for you. This guide is for general information and educational purposes only. Regular check-ups and awareness can help to manage and prevent complications associated with these diseases conditions. If you or someone are suffering from this disease condition bookmark this website or share with someone who might find it useful! Boost your knowledge and stay ahead in your health journey. We always try to ensure that the content is regularly updated to reflect the latest medical research and treatment options. Thank you for giving your valuable time to read the article.

The article is written by Team RxHarun and reviewed by the Rx Editorial Board Members

Last Updated: December 16, 2025.