When Should You Have Surgery for Diastasis Recti?

Question

My MRI WO/W contrast findings: 1. There is a mild diastasis of the rectus abdominis muscle, by approximately 2cm. However, there is no herniation of intraperitioneal contents. 2. Mild fatty infiltration of the liver. No focal hepatic abnormality. 3. There is circumferential thickening of fascia around the anterior and lateral abdominal wall. I am 5ft 5inch & 143 lbs, very active. There's discomfort. I cannot do many of my sports activties. Can it be reversed or do I need surgery?

David A. Bottger, MD · Answer

A mild diastasis recti is a common finding and usually should not give you pain symptoms as would for instance a hernia. A diastasis combined with generalized abdominal wall laxity would produce more prominence of the abdomen in that area- a cosmetic issue. A tummy tuck would incorporate repair of the diastasis as well as excision of excess skin and potentially fat removal depending on each individual patients issues.

Richard J. Bruneteau, MD · Answer

It’s not unusual for patients to develop diastasis of the
rectus muscles following pregnancy. Conversely, it would be extremely rare for
this problem to cause significant abdominal pain. Under these circumstances,
another diagnosis would be more likely.Correction
of a diastasis recti involves suture repair of the gap between the pubic bone
and the rib cage. This repair requires exposure of the underlying muscles by
separating them from the overlying skin. Once this maneuver has been performed
you have essentially performed an abdominoplasty.Under
these circumstances, it would be pointless to repair a diastasis without
performing an abdominoplasty.Unfortunately this maneuver might not impact your abdominal discomfort.

David Shafer, MD, FACS · Answer

It is not unusual to have a minor diastasis recti (separation of the rectus muscles), especially in women.  in most cases, there is not a medial need to have it repaired.  It is basically just a description of an anatomical finding, not a condition that needs repairing.  If your MRI showed a hernia or other abnormality, then that may need to be fixed.  During abdominoplasty / tummy tuck, the diastasis is usually repaired, but this is for cosmetic reasons to help give the stomach / abdomen a flatter appearance.  In some cases, repair of the diastasis or just a tightening of the muscles does reduce back pain in some patients as it helps bring everything into alignment.  

	 

	Good Luck.

Martin Jugenburg, MD · Answer

Rectus diastasis of 2 cm without herniation not unusual.  This does not require surgery.  This MRI alone does not explain why you're having discomfort but a tummy tuck or rectus repair is certainly not the treatment for your pain

	Sincerely,

	Martin Jugenburg, MD

Carmen Kavali, MD · Answer

A 2 cm diastasis is not severe at all and should not be causing any pain. It is not necessary to repair it. If you're done having children, though, and are ready for a tummy tuck, then the repair would be part of that surgery. But don't expect it to resolve this pain you're having.

David Bogue, MD · Answer

A 2cm diastasis is unlikely the cause of your symptoms. A diastasis is essentially a separation of the muscles which is very common, particularly if you have been pregnant. This is not the same as a hernia. Correction of a diastasis is elective as the functional consequence is minimal, but it rarely "needs' to be fixed. The discomfort you are having with sports and activities is something to bring up with your primary care physician as there are many causes for this general complaint.

Peter E. Johnson, MD · Answer

A mild diastasis is the normal finding for most women after pregnancy. A diastasis alone is not an indication that a repair is needed and in itself there should be no physical limitation. Exercise should help, surgery, no.
	Best of luck,
	peterejohnsonmd

Sugene Kim, MD, FACS · Answer

I agree with my colleagues. Mild diastasis recti is common in women. I doubt that diastasis recti is the cause of your discomfort. Perhaps the circumferential thickening of your fascia may be the cause; however, this needs to be worked up by your GI or primary care physician. In terms of correcting the diastasis recti, this is usually done at the time of tummy tuck. Tummy tuck is a great procedure to contour your abdomen. Tummy tuck involves removing excess lower abdominal skin and muscle as well as repairing the diastasis recti. Repair of diastasis recti is an elective procedure that is normally done during tummy tuck.

Edward J. Domanskis, MD (in memoriam) · Answer

A diastasis recti should not be causing much pain or discomfort,esp one that small. All a diastasis is is a separation of your muscles and really not a true hernia. It is esp common after pregancy. I do repair it during a tummy tuck but I would look at other causes of your pain. Watch my video.

E. Anthony Musarra II, MD (in memoriam) · Answer

Repairing a diastasis of the rectus fascia before a pregnancy is a huge waste of money, because it will be ruined by the pregnancy. Wait until the pregnancy is over by at least 6 months, then go for it.

When Should You Have Surgery for Diastasis Recti?

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