Creating a baby is one of the most incredible things your body can do. But with that amazing journey comes change, including postpartum belly and umbilical hernias, conditions some women experience after giving birth.
Diastasis recti (DR), sometimes called postpartum belly or abdominal separation, is a condition that occurs when the connective tissue, or fascia, that bridges the abdominal wall between the abdominus rectus muscles (six pack muscles) weakens and stretches. This separation can make a person's belly stick out or bulge.
An umbilical hernia forms when a section of intestine or other tissue pushes through a weak spot in the abdominal wall near the belly button.
Austin Surgeons board certified general surgeon Dr. Mark Glover answers patients’ common questions about diastasis recti and umbilical hernias.
Can diastasis recti cause a hernia?
Diastasis recti is similar to a weak protrusion on an inner tube. While diastasis recti does not cause a hernia, it is a risk factor for having a hernia. The weakened fascia is more likely to tear open creating a hernia.
How can you tell the difference between diastasis recti and a hernia?
It's hard for most patients to tell the difference between the two on their own, as they both present as a bulge. Commonly, an umbilical hernia will present as a circular enlarging "outie," whereas diastasis recti will look like a tall ridge running from the bottom of the sternum all the way down to the navel.
What happens if diastasis recti is left untreated?
Unlike a hernia, diastasis recti does not continue to enlarge unless there is progressive weight gain. It doesn't result in any sort of emergent situation, like hernias do.
Traditionally diastasis recti was thought to be solely a cosmetic issue. However, further research has shown that diastasis recti may be associated with low back pain, decreased core strength or difficulty urinating.
What happens if an umbilical hernia is left untreated?
Umbilical hernias are usually not symptomatic at first. It takes some time to become large enough for the bowel or intestine to fit through the hernia. At first fatty tissue will protrude through the hernia. But even fatty tissue stuck in the hernia can cause pain or fatty necrosis.
Hernias do not go away and will continue to enlarge over time. Sometimes that happens slowly over years, but factors that make it enlarge more rapidly would be weight gain, coughing and constipation.
When is surgery used to treat diastasis recti or umbilical hernia?
Diastasis recti may be treated surgically by suturing the fascia back together. This procedure is called plication. The complicated question is not can the diastasis be repaired but should it.
Diastasis is usually caused by pregnancy or weight gain. Plication is not ideal if the abdominal wall is still on significant tension, as plication will put the abdominal wall on more tension. Plication is ideally performed when the tension that created the diastasis has resolved, usually at least six months postpartum or after significant weight loss.
If diastasis and hernias are both present, it is sometimes necessary to plicate the diastasis at the same time as a hernia repair.
Anything else new moms should know about hernias or diastasis recti?
During pregnancy a hormone called relaxin aids in stretching of the abdominal wall. After delivery it takes six to 12 months for the abdominal wall to return to some sort of baseline.
While diastasis will not resolve completely on its own, most women can expect about a 50 percent reduction in the width of diastasis recti with proper exercise and time.
For more information about diastasis recti and hernia surgery, visit austinsurgeons.net or call (512) 467-7151.
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