Abdominal diastasis: what it is, risk factors, symptoms and remedies

Noemi Bocchi, Francesco Totti’s partner, has revealed that she has this problem

Roberto De Filippis

February 25th

To turn the spotlight on abdominal diastasis was the confession via social media of Noemi Bocchi, the companion of the flag of Rome Francesco Totti. In fact, this is a fairly common problem; affects mainly women and often manifests itself after childbirthespecially when carrying more than one pregnancy to term.

THE ABDOMINAL DIASTASIS IS CAUSED BY THE INCREASE OF PRESSURE

Under normal conditions the rectus abdominis muscles, formed by two longitudinal bundles that go from the sternum to the pubis, are almost united along the so-called “sunrise line”, a small depression in the center of the abdomen, which is more evident the more the muscles are developed. In the absence of problems, the linea alba does not exceed 1.5 centimeters, while in those with abdominal diastasis this distance is greater. This involves not only theestrangement of the two rectus muscles, but also theirs thinning And stretching; moreover, these muscles take on a curvilinear shape. The increase in intra-abdominal pressure determines the increase in the distance between the rectus muscles. “The typical condition that leads to the appearance of abdominal diastasis is pregnancy. In fact, gestation involves not only an increase in the volume of the abdominal cavity, but also in internal pressure” underlines the professor Giampiero Campanellidirector of the Hernia Center of the Casa di Cura La Madonnina in Milan and head of the General Surgery Day & Week Surgery service of the Irccs Galeazzi-Sant’Ambrogio Hospital in the Lombard capital and full professor of Surgery at the University of Insubria.

ABDOMINAL DIASTASIS: HERNIAS MAY BE ASSOCIATED

Especially if the mother is young, not overweight and has toned abdominal muscles, the situation often returns to normal after giving birth. Sometimes, however, the rectus muscles remain not only distant, but also stretched and protruding outwards. “Generally we notice diastasis when the abs are stressed to perform simple gestures, such as getting out of bed, and we notice a little ‘hump’ in the center of the belly. In some cases, umbilical or epigastric hernias may also appear, from which more or less large portions of the abdominal organs protrude,” says Professor Campanelli. Abdominal diastasis can also be associated with a decay of the skin and subcutaneous tissue, with related stretch marks. This problem does not cause pain, just a feeling of heaviness and a feeling of lack of strength in the abdomen. “Lately, sufferers often complain of a lower back pain, which could be attributable to the incorrect position assumed following the loss, by the rectus muscles, of their anterior hinge function. Other women also complain of incontinence problems, which however can also depend on the descent of the pelvic floor which can occur after childbirth” observes the expert.

ABDOMINAL DIASTASIS: THE SCALPEL IS NOT ALWAYS NEEDED

In case of suspected diastasis recti to get to diagnosis you have to undergo two tests: a dynamic ultrasound and a dynamic CT scan of the abdomen, which is even more precise and thanks to which you can observe the conditions of the rectus muscles and the possible presence of hernias. Once the problem has been diagnosed, based on various factors (weight, muscle tone, thickness and distance of the rectums, presence of hernias, desire for other pregnancies, etc.) it is decided which treatment is most suitable. If the patient is lean and has good muscles, if the rectums are not too thin and no more than 2.5 centimeters apart and there are no hernias, to resolve the diastasis it is almost always sufficient to carry out regularly exercises to strengthen the transverse muscles of the abdomen. If, on the other hand, the situation is more compromised, surgery is required. If the woman is relatively interested in the aesthetic result a network is positioned behind the rectus muscles, which are brought together and returned to their natural position. “This solution can be approached in two ways: with a small 5 cm incision between the sternum and the navel or, thanks to the aid of a robot, with an operation without cuts, but with 3 or 4 small holes on the abdomene” explains Professor Campanelli. Those who care more about the aesthetic aspect can undergo an operation that provides for the same “repair”, but through a small arch-shaped incision above the pubis, through which to also create atummy tuck partial or complete.



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