Superior Mesenteric artery syndrome

[bonbon143]

I had surgery for SMAS 3 years ago and my digestive health improved completely. Just recently I have started getting the same symptoms I used to have before the surgery. I was wondering if it is possible for the syndrome to occur again or come back? Please help!

[CalGal]

It's very unusual for the situation to happen again. And many of the symptoms that are seen with SMA syndrome can be duplicated with other GI issues. But the best thing to do is to call your doc and get some testing done to find out what is going on.

[RedViolin87]

I have SMA syndrome and I know that nothing else can recreate its  horror.  If you are feeling the same *exact* pains, chances are, it is related and not something else.  Take a look at this article - http://www.wjgnet.com/1007-9327/14/303.pdf .  It was published in the World Journal of Gastroenterology two weeks before I had a duodenojejunostomy in 2008.  It answers the question:  Why can SMAS patients still experience similar pain and symptoms even after surgery, if the constriction is bypassed or eliminated? The article states: “The main character of SMAS is that the reversed peristalsis is greater than the direct peristalsis, which is the most important reason inducing the symptoms. . . Only releasing from obstruction by operation cannot alleviate clinical symptoms because the strong reversed peristalsis still exists."  Basically, during the illness, the intestines learn to accommodate the constriction by pumping backward.  After surgery, when the constriction is bypassed, the enteric nervous system doesn't instantly 'forget' to stop doing this.  And it is this reversed peristalsis that causes the pain.

This may not be what's happening to you, but it's a thought.  What kind of surgery did you have?  Now there are lots of options for SMAS.  (See the "Treatment" section here for a complete list of them all: http://wikipedia.org/wiki/SMA_syndrome ). If you had a gastro- or duodenojejunostomy, sometimes the surgical anastamosis can accidentally twist or kink up over time, which means SMAS symptoms would recur if you were still relying on the bypass (if the constriction is still there).

Hope this helps :)