Diastasis recti
Definition
Diastasis recti is a noticeable separation between the left and right rectus abdominis muscles. These muscles cover the front surface of the belly area, and are normally joined together in the midline by a narrow, thickened band of connective tissue (called the linea alba). If this connective tissue in the midline becomes thinned and widened, the muscles will be farther apart from each other. This may allow an outward bulge in the middle of the abdomen, going from the breastbone down to the belly button.
Causes
Diastasis recti may occur in premature infants, where the abdominal muscles are not well-developed.
Pregnant women may more commonly develop the condition because of increased tension on the abdominal wall. The risk is higher with multiple births or many pregnancies. Men can sometimes develop it. Obesity can produce it due to increased pressure on the abdominal wall.
Symptoms
A diastasis recti looks like a ridge, which runs down the middle of the belly area. It stretches from the bottom of the breastbone to the belly button. It increases with muscle straining.
In infants, the condition is most easily seen when the baby tries to sit up. When the infant is relaxed, you can often feel the edges of the rectus muscles.
Diastasis recti is commonly seen in women who have multiple pregnancies. This is because the muscles have been stretched many times. Extra skin and soft tissue in the front of the abdominal wall may be the only signs of this condition in early pregnancy. In the later part of pregnancy, the top of the pregnant uterus may be seen bulging out of the abdominal wall.
Exams and Tests
Your health care provider can diagnose this condition with a physical exam. The edges of the right and left rectus abdominis muscles are usually easily felt when you are lying down. Sitting up or coughing then can cause the midline to bulge outward, between the edges of the muscles.
Treatment
No treatment is needed for pregnant women with this condition. It may improve after delivery.
In infants, diastasis recti will disappear over time. Surgery may be needed if the baby develops a hernia that becomes trapped in the space between the muscles.
Outlook (Prognosis)
In some cases, diastasis recti heals on its own.
Pregnancy-related diastasis recti often lasts long after the woman gives birth. Exercise may help improve the condition. Umbilical hernia may occur in some cases. Surgery is not usually performed for diastasis recti.
Possible Complications
In general, complications only result when a hernia develops. This may be at the belly button or just above it, since the hernia occurs through the widened, thinned connective tissue.
When to Contact a Medical Professional
Contact your provider right away if a child with diastasis recti:
- Develops redness or pain in the abdomen
- Has vomiting that does not stop
- Cries all the time
References
Chabra S, Anderson JE, Javid PJ. Abdominal wall defects. In: Gleason CA, Sawyer T, eds. Avery's Diseases of the Newborn. 11th ed. Philadelphia, PA: Elsevier; 2024:chap 62.
East B, de Beaux A. The abdominal wall and hernia. In: Garden OJ, Parks RW, Wigmore SJ, eds. Principles and Practice of Surgery. 8th ed. Philadelphia, PA: Elsevier Limited; 2023:chap 12.
Privratsky AM, Barreto JC, Turnage RH. Abdominal wall, umbilicus, peritoneum, mesenteries, omentum, and retroperitoneum. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 21st ed. St Louis, MO: Elsevier; 2022:chap 44.
Reviewed By: John Meilahn, MD, General Surgeon, Wyndmoor, PA. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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