What is abdominal diastasis?

The abdomen has a pair of longitudinal muscles located in the center, side by side. These are known as the rectus abdominis muscles, which form the well-known “six-pack” when hypertrophied through exercise. When these muscles separate by an abnormal distance (greater than 2 cm), the condition known as abdominal diastasis or diastasis recti occurs. This can result, in some cases, in the protrusion of internal abdominal contents, which are now less protected.

Symptoms

This condition is usually easily identified clinically. As mentioned, the abdominal contents become exposed in the central area, and when intra-abdominal pressure increases — such as when standing up or coughing — they protrude even more, forming a bulge along the vertical midline of the abdomen. The condition typically does not present other symptoms.

Types

The condition can be congenital (present at birth) or acquired.

Causes

In the case of acquired diastasis, it may occur due to: intense abdominal obesity, rapid and significant weight loss, pregnancy (especially with large uteruses, such as in twin pregnancies, in very thin women), advanced age.

Prevention

To prevent acquired diastasis, two actions are important: engaging in physical exercises that strengthen the abdominal wall and maintaining a healthy weight, avoiding obesity.

Diagnosis

Diagnosis is clinical, based on the physical examination findings mentioned above. Sometimes, obesity can hinder identification and raise doubts about the presence of diastasis. In such cases, imaging tests like ultrasound and CT scans can clarify the diagnosis and determine the defect and its extent.

Treatment

Given the low risk of complications associated with this condition, but considering aesthetic concerns, the preferred treatment is clinical and mainly involves weight loss and abdominal muscle strengthening exercises.

Spontaneous resolution may occur, especially in children. In rare cases, surgery is performed to bring the muscles back together, particularly in very large defects that do not improve with standard measures. Since these cases often also involve skin laxity, plastic surgeons usually perform the repair as part of a combined aesthetic procedure.

By Einstein Editorial Board