Dr. Danny Shouhed

Dr. Danny Shouhed Performing advanced treatments or surgery for abdominal and gastrointestinal disorders are our specialties at the practice of Danny Shouhed, M.D.

in Beverly Hills CA. https://linktr.ee/DrDannyShouhed

08/12/2026

When MALS and SMAS occur together, symptoms can become more confusing. You might have pain immediately after eating from one condition, and delayed symptoms from the other.

Patients often feel like nothing fits into a clear category. That overlap is important to recognize because it directly affects treatment planning. In some cases, addressing one condition is enough to improve things. In others, both need to be treated.

The key is understanding what is driving the symptoms. This is where a detailed history and a thoughtful, experience-driven approach really matter, because treating the wrong driver can lead to incomplete results.

It’s not simply about identifying conditions, but about prioritizing them correctly to create a plan that actually works for the patient.

If you’ve been told your scans are ‘inconclusive’ or your symptoms don’t make sense, don’t stop there. Get a second opinion, ask deeper questions. I’m here to help if you have questions. These overlapping conditions are nothing new to me, and the right interpretation can change everything for your long-term health.

07/27/2026

MALS and SMAS surgeries are not routine, high-volume procedures. The anatomy is complex, and small details can make a big difference in outcome. Knowing how much to release, how to handle nerves, and how to recognize subtle anatomical variations. And that all comes with experience over time. Just as important is recognizing when something else might be going on. That level of judgment only develops from seeing many cases and following patients long-term. At the same time, one of the biggest challenges is that symptoms don’t always match the scan. Imaging can look borderline or even normal, but the patient’s symptoms are very real and often very consistent. That’s where experience really matters. We look at patterns: when the pain occurs, how it progresses, and what makes it better or worse. Sometimes, additional tests like nerve blocks help confirm what we suspect. And for patients, it’s worth asking not just ‘can this be done,’ but ‘how often is it done, and how is the decision made?

07/15/2026

If you’re not feeling better after MALS surgery, there’s usually a logical reason for it. The first thing I look at is the technique. In an MALS procedure, you not only release a ligament but also properly address the nerves around the celiac artery. If that part isn’t done completely, the pain can stick around. Second is experience. These cases aren’t always straightforward. The anatomy can vary, and if you’re not used to seeing those variations, it’s easy to miss part of the problem. Third is patient selection. Just because an artery looks compressed doesn’t always mean it’s the cause of your symptoms. That’s where things like a nerve block become really important in predicting who will actually benefit. And finally, a big one: overlapping conditions. A lot of patients with MALS also have other GI issues, like motility disorders or sensitivities. If those aren’t addressed, you may feel like the surgery didn’t work, even if part of the problem was fixed. So when someone doesn’t improve, I don’t assume the surgery failed; I assume we need to take a step back and figure out what piece of the puzzle we’re missing. If you’ve had a MALS procedure and still don’t feel quite right, book a consultation with me today.

07/13/2026

For many patients, the goal of treatment isn’t simply to relieve symptoms. It’s getting back to the moments that matter most.

Sharing a meal with family. Enjoying time outdoors. Feeling like yourself again.

We’re grateful to this patient for sharing their experience and for trusting Dr. Shouhed and our team with their care. Hearing how treatment has helped them return to the activities they love is why we do what we do.

If you’re living with persistent digestive symptoms or have been diagnosed with a complex gastrointestinal condition, Dr. Danny Shouhed provides specialized evaluation and treatment to help patients find answers and explore personalized treatment options.

07/08/2026

I think it’s important to be honest about this: MALS surgery is a big step, but it’s not always the entire answer right away. Even when the surgery is done well, the body has been dealing with this for months or years. The nerves have been irritated, eating patterns have changed, and the gut often slows down or becomes more sensitive over time. So symptoms like bloating, nausea, or irregular digestion can still be there early on. In some cases, there may also be another diagnosis, like SMAS, that’s contributing to what you’re feeling. That’s why I always look at the full picture, not just the compression. Surgery addresses the structural issue, but recovery is a process. There’s often a second phase where we focus on getting the gut functioning normally again, whether that’s through diet, medications, or working with other specialists. So if you’re not feeling better right away, it doesn’t mean the surgery didn’t work. It means your body is still catching up, and we need to support that process.

06/29/2026

When you’ve been searching for answers for a long time, finally finding them can change everything.

Every patient’s journey is unique, but one thing remains the same: our goal is to help patients feel heard, informed, and supported from diagnosis through recovery.

We’re grateful to this patient for sharing their experience and for trusting Dr. Shouhed and our team with their care. Stories like this remind us why we do what we do.

If you’ve been living with persistent digestive symptoms or have been diagnosed with a complex gastrointestinal condition, Dr. Danny Shouhed provides specialized evaluation and treatment for patients seeking expert care and personalized solutions.

06/17/2026

When patients start researching SMAS, they often come across different surgical names, which can feel overwhelming. The unfortunate reality is that there isn’t just one ‘silver bullet’ operation that works for everyone.

The most common is a duodenojejunostomy, where we bypass the compressed portion of the intestine. In other cases, a Strong’s procedure may be appropriate, which partially releases attachments to help reposition the bowel.

Today, I favor performing the duodenal derotation with the duodenoduodenostomy. I also evaluate whether or not MALS surgery needs to be performed at the same time. My approach is to choose the option that gives you the most reliable relief with the least disruption to your body. That’s why a careful workup matters so much beforehand. I want to match the right solution to the right patient, not merely pick a procedure and hope it works out. If you’ve been struggling with symptoms that seem like MALS or SMAS, come in for a consultation, and I’ll guide you to the right path for relief.

06/03/2026

With MALS, one pattern we see is that eating becomes uncomfortable, so patients naturally eat less.

Over time, that leads to weight loss. The challenge is that the fat pad between the arteries in your abdomen starts to shrink as you lose weight. That space is what helps prevent compression of the duodenum. So as it disappears, patients can go on to develop SMAS.

At that point, you’re dealing with a second issue that’s often more difficult to recover from. That’s why timing matters. We don’t necessarily need to rush into surgery, but if symptoms are progressing and weight is dropping, it’s important not to ignore that trend.

If you’re noticing that pattern in yourself (eating less, losing weight, symptoms getting worse), it’s worth getting evaluated sooner rather than later. Catching this early can make a big difference in how complex things become.

05/29/2026

You wouldn’t want a pilot who ‘dabbles’ in landings, right? Then why settle for a surgeon who ‘dabbles’ in MALS or SMAS? These are incredibly complex, high-stakes issues. I see this scenario all the time: surgeons who are excellent at common procedures, like gallbladder surgery, trying their hand at a MALS release. But if you don’t fully decompress the nerve, or you’re not recognizing how these syndromes overlap, patients don’t get better, and sometimes they don’t know why. In my practice, this is all I focus on. I’m constantly correlating symptoms, imaging, and things like nerve block response to make sure we’re treating the right problem the right way. Because a technically “successful” surgery doesn’t mean much if the patient still has pain afterward. A lot of these cases don’t look like the textbook. The anatomy can vary, the symptoms can overlap, and that’s where experience really matters — knowing what to look for, what to address, and just as importantly, what not to miss.

05/22/2026

Over the years, as a surgeon, I’ve noticed that MALS and SMAS are often treated as completely separate problems. You’ll see physicians who focus on MALS, and others who focus on SMAS, but not many who are really looking for both at the same time. The issue is, anatomically, they sit right next to each other. So if a patient has one, it’s not a stretch to think they may have the other or may develop it over time. I see a number of patients who’ve had surgery for one condition and don’t fully improve, and when we take a closer look, there’s a second compression that was never addressed. It’s not that anything was done ‘wrong,’ it’s just that the full picture wasn’t considered. For patients, this can be frustrating because they feel like they did everything right and still aren’t better. In my practice, I try to evaluate both from the beginning, because treating one without at least thinking about the other can leave part of the problem behind. Book a consultation with me, and we’ll make sure we don’t miss anything.

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