Abdominal diastasis: causes, symptoms, and solutions

Abdominal diastasis is a condition that mainly affects women postpartum but can also appear in overweight men. «During pregnancy, the separation of the rectus abdominis muscles is a physiological process that allows the uterus to expand in order to accommodate the baby. If this separation persists for more than six months after childbirth, it becomes a pathological condition that leads to instability of the abdominal wall», explains Giovanni Marangi, plastic surgeon and associate professor of plastic surgery at the Policlinico Campus Biomedico Hospital in Rome.

To identify the presence of this condition, the first step is a specialist consultation. Even just palpating the abdomen and performing a physical examination can provide significant insights and help assess the severity of the condition.

«There are also important diagnostic tests such as ultrasound, which can quantify the extent of the diastasis – says Dr. Marangi -. When necessary, an MRI can be performed, this is a second-level test that provides even more precise characteristics of the diastasis».

Postural problems as a consequence

Symptoms can range from simple bloating and a sense of abdominal wall instability to issues not strictly related to the abdominal area, such as urinary incontinence and back pain. The weakness of the abdominal wall can affect posture, leading to strain on the lumbar muscles.

Treatment may include types of hypopressive exercises. «These are physiotherapy treatments that can be useful for mild diastasis  – says Marangi -. In moderate to severe cases, the most effective approach is surgical correction. This can involve simply repositioning the rectus muscles with sutures, or using mesh reinforcement in more severe cases».

Often, excess skin left after pregnancy also needs to be addressed. «There is a need to correct not only the structural part but also the skin envelope through abdominoplasty», adds the doctor.

Innovations in treatment

If left untreated, abdominal diastasis can lead to more serious issues: «For example, abdominal wall hernias, which can risk strangulation, or even eventration, a condition where abdominal organs protrude outside the abdominal cavity. These complications, along with issues like incontinence, constipation, and pain, can worsen and significantly impact a patient’s quality of life». 

Treatment approaches have evolved significantly with the introduction of laparoscopic or minimally invasive surgery. «Through small incisions, the diastasis is corrected from inside the abdominal cavity.

This technique is less invasive than traditional surgery but should only be used in cases where there’s no excess skin to be removed. It’s not suitable when skin resection is also needed to improve the abdomen’s appearance».