Celiac Plexus Block
There is a lot of misinformation about the celiac plexus block out there and this page is supposed to help with that. This page is based on medical journals, research and studies.
The celiac plexus is a bundle of nerves connected to the Celiac Ganglia. This nerve cluster serves the liver, pancreas, gallbladder, stomach, spleen, kidneys, and intestines.
What is the Celiac Plexus?
The nerve block is an injection of medication put directly into the Celiac Plexus. The cocktail usually includes numbing medication, steroids, and an anti-inflammatory. Every doctor has their own cocktail that they use so your block will differ depending on whom you see.
What does the Celiac Plexus Block do?
The goal of the procedure is to block your nerves from sending pain signals to a part of your abdomen. This block is purely to remove pain. It isn’t designed to get rid of nausea, vomiting, diarrhea, or constipation. Some people have found their other GI symptoms do decrease or go away after having the block but that isn’t what the block is designed to do.
How is the Celiac Plexus Block procedure done?
There are two ways to do a celiac plexus block; one is from the back which is the most popular way. The other is to use a scope that goes down your throat and use an ultrasound probe to guide them into your plexus to inject the medication.
On average you are given medication to help you relax and you receive twilight sedation. Twilight sedation will make you forget the event itself but this is what happens while you are sedated. A pain specialist will numb the skin on your back. Then they’ll use x-ray imaging to insert thin needles into your back on both sides of your spine. They’ll inject dye to make sure they stick you directly into your celiac plexus. Once they find the plexus they inject the pain medication to block the nerves from carrying pain signals to your abdomen. You may find that you have a sore back after the procedure.
This is a less common procedure for MALS patients but it is widely used for other abdominal related illnesses. This procedure involves going under anesthesia as you are having a camera put down your throat. The ultrasound on the scope then locates the aorta and follows it until it finds the celiac trunk. Once they locate the celiac plexus a needle is passed through the scope and the medication is injected into the plexus. Similar to the other block, the medication is supposed to block the nerves from carrying pain signals to a part of your abdomen.
How will I feel after the block?
If you have had a positive response to the block you should feel some relief from your MALS pain and maybe even your symptoms as a whole. It varies from person to person for how long this will last. It can last for a few hours or even a few years. You have to keep in mind that this is supposed to be temporary. It's treating the symptoms of MALS, it's not going to fix it.
Are there negative side effects to a block?
Yes, just like any other medication there is a risk of having negative side effects. The most common response is diarrhea and decrease in blood pressure. So if you have low blood pressure normally that is something to discuss with your doctor before undergoing the procedure.
Can a celiac plexus block alone tell you if you have MALS?
No, a plexus block alone isn't a diagnostic tool for MALS. Plexus blocks are used for a multitude of illnesses to help control symptoms. So if you get a positive result from the plexus block that doesn’t necessarily mean you have MALS. Getting a negative result doesn’t mean you don’t have MALS. In that way, it is hard to use a plexus block alone to give a MALS diagnosis without other positive tests like a CTA, MRA, or Ultrasound.