Recti-diastasis
In this condition, there is a wider than normal separation of the rectus abdominis muscle (also known as the ‘6-pack’ muscle)
Rectus abdominis muscles.
The tissue between the rectus abdominis muscle is a fascia (tough tissue but is not muscle). When the abdominal pressure is increased (with coughing, abdominal straining, lifting weights) there is bowing out this facia layer. This gives the appearance of a lump in the centred in the midline area of the abdomen, above the belly button.
However, as there is no abnormal organ protruding through a muscular defect, it is not a hernia and therefore does not have the risk of hernia complication.
Cross section of the area.
This diastasis is the result of unbalance force acting on the abdominal wall, with increased pressure pushing against the abdominal wall. As the midline fascia is not a muscle, it is not able to provide a counterbalance to this additional pressure. As a result, it is stretch and will bow outwards to produce the bulge seen clinically.
Common causes of recti diastasis
- pregnancy
- chronic increased intra-abdominal pressure—such as advanced liver disease
- obesity
- incorrect exercise.
Symptoms
- The commonest presentation symptom is that of a bulge in the midline of the abdomen. At the early stage, this may be mistaken as increased weight. It may also be noticeable only when the patient is involved in certain activities.
- Abdominal pain.
Clinical examples
Management
- Physiotherapist and exercise. It is important that the exercise is carefully selected and monitored, as the wrong type of exercise can make the diastasis bigger.
- Surgery
Open repair
This is done through a medium length incision in the middle of the abdomen.
Laparoscopic repair
This repair is performed through several small incisions in the abdominal wall allowing the repair to be done from the inside of the abdomen.
Clinical Associate Professor Hairul Ahmad MBBS FRACS
Upper Gastrointestinal, Advanced Laparoscopic and General Surgery
Perth, Western Australia
Perth, Western Australia
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