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What You Should Know About Diastasis Recti

What is diastasis recti?

You may have heard about diastasis recti in postpartum women, but the condition can affect anyone, including men. The most notable symptom of diastasis recti is a noticeable pooch in your stomach. This pooch is caused by weakness and separation of the muscles in the mid-abdomen. The mid-abdomen is commonly called your abs.

Keep reading to learn more about this condition and the available treatments.

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Symptoms

What are the symptoms of diastasis recti?

If you have diastasis recti, you’ll likely notice a pooch or bulge in your stomach. It may be more noticeable when you strain or contract your abdominal muscles, such as when you sit up. In addition to the stomach bulge, you may also experience:

  • lower back pain
  • poor posture
  • constipation
  • bloating

Causes

What causes diastasis recti?

Diastasis recti occurs when too much pressure is put on your abdominal muscles. This can cause them to stretch and separate. The separation in the muscles allows what’s inside of the abdomen, mostly the intestines, to push through the muscles. This forms a bulge.

The most common cause for diastasis recti is pregnancy. This is because the growing uterus puts pressure on the abdominal muscles, causing them to stretch and separate. The condition can also occur in men or in women who have never been pregnant.

Obesity can cause diastasis recti because the excess fat deposits put additional pressure on the stomach muscles. Additional causes include:

  • frequent or rapid changes in weight
  • weightlifting
  • some abdominal exercises
  • long- or short-term swelling of the abdomen related to fluid inside of the abdominal cavity from conditions such as cirrhosis of the liver or cancer within the abdomen
  • advanced age
  • genetics

Diastasis recti also occurs in newborns babies, particularly those born prematurely, because their abdominal muscles aren’t fully developed. It usually resolves without treatment.

A few case reports discuss diastasis recti occurring in men with HIV. This is because HIV alters the way the body stores fat and relocates some of it to the abdominal cavity. Relocation of fat in the abdomen may cause increased intra-abdominal pressure. The increased pressure can put people who have HIV at an increased risk for diastasis recti.

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Risk factors

What are the risk factors for diastasis recti?

You’re at risk for diastasis recti if you regularly put an increased amount of pressure on your abdominal muscles. This includes people with excess abdominal fat, those who perform exercises that stress their abdomen, or pregnant women.

Even everyday moves done incorrectly can weaken the abdomen, says Beth Jones, a certified athletic trainer in Parker, Colorado. For example, you should avoid bending over to pick up heavy packages. Instead, you should pick up heavy objects, including weights, by squatting and lifting.]

Researchers in one study looked at men with an abdominal aortic aneurysm (AAA) and found that this condition might increase your risk for diastasis recti. An AAA occurs when the large vessel that carries blood to your abdomen swells. This can be a life-threatening condition.

According to the study, diastasis recti was present in about two-thirds of men with an AAA. Furthermore, they found that diastasis recti was present in four times more men with an AAA than in the control group made up of men with a different vascular condition. The connection between diastasis recti and AAA isn’t fully understood. Some researchers believe a collagen disorder could be responsible for the connection.

Diagnosis

How is diastasis recti diagnosed?

Doctors can usually diagnose diastasis recti during a physical exam. To diagnose your condition, your doctor will ask you to lie flat on your back and then perform a half situp, or a crunch. If you have diastasis recti, a vertical bulge will appear between your abdominal muscles. Your doctor can measure the gap between your muscles to determine the severity of your condition. They may measure the gap using various methods, including:

  • calipers
  • a CT scan
  • an ultrasound 
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Treatments

What treatments are available?

Several treatments are available for diastasis recti. Work with your doctor to determine which treatment is right for you. Some people choose to do nothing. Often, the condition doesn’t cause any health issues but is instead a cosmetic issue.

Exercise may help treat diastasis recti, but research is limited. Talk to your doctor about exercises that are safe for you to do. They’ll likely recommend exercises that strengthen your abdomen, back, and hips.

Jones generally recommends core-strengthening routines such as Pilates or yoga to prevent or treat diastasis recti. She notes that it’s crucial to make sure you do the exercises correctly. Exercises such as powerlifting can bring on the condition or make it worse if you do them incorrectly. Work with your doctor or a physical therapist to learn the correct way to do any core-strengthening exercises. You may also benefit from using a belt to stabilize your core.

Surgery

You may need surgery to treat diastasis recti. Surgery may be conventional, laparoscopic, or endoscopic. Conventional surgery involves a standard incision in the abdomen. One type of comprehensive surgery is abdominoplasty, or a tummy tuck. In addition to correcting the diastasis recti, an abdominoplasty also usually involves the removal of excess skin, tissue, and fat from the area.

Laparoscopic surgery uses small incisions for a tube that guides a light, a camera, and surgical tools to the site of the surgery. Endoscopic surgery is similar to laparoscopic surgery. Your doctor will insert a light, camera, and tools through the throat and esophagus rather than make an incision in your abdomen. Recovery time from laparoscopic and endoscopic surgery is shorter than recovery time from conventional surgery.

The most common complication of diastasis recti surgery is the collection of fluid under the skin. Other common complications include:

  • hematomas
  • minor skin loss
  • wound infections
  • rupture of the wound
  • pain after surgery
  • nerve damage

In some studies, the condition reoccurred as often as 40 percent of the time in people treated with surgery.

Learn more: How to tell if you’ll need diastasis recti surgery »

Your doctor will work with you to determine the best type of surgery for you. For example, endoscopic surgery isn’t recommended for people with an extensive amount of loose skin or excess fat in the abdomen.

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Outlook

Outlook

You may be able to correct diastasis recti through exercise. Work with a skilled trainer or physical therapist. This will help you to do the exercises correctly and prevent making the condition worse.

If you’re overweight, losing weight and keeping it off can help prevent diastasis recti from recurring after it has resolved. If you’re a weightlifter or often do a lot of abdominal exercises, make sure you’re doing the exercises correctly to help prevent the condition from recurring.

If you’re concerned about diastasis recti, talk to your doctor. They may be able to treat it surgically.

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