Medical Consultant Gastroenterology Diastasis of the rectus abdominis muscles: causes, symptoms and treatment
Diastasis of the rectus abdominis muscles is most common in women after childbirth and occurs as a result of excessive stress during pregnancy. But men, nulliparous girls and even children are not immune from this problem. The discrepancy of the peritoneal muscles brings not only aesthetic inconvenience, but also causes a number of complications. To avoid health problems and surgical intervention, if characteristic signs of the disease are detected, it is necessary to begin treatment.
- Stages
- Causes
- Symptoms and external manifestations
- Diagnostics
- Treatment methods
Physical exercise
- Taping
- Surgery
What is diastasis
Diastasis recti is the separation or separation of muscles to the left and right of the midline. This leads to expansion and thinning of the linea alba, as well as a longitudinal protrusion of the anterior abdominal wall, which is located above the navel. The linea alba is a formation of the peritoneum, in which connective fibers are intertwined, coming from both sides of the rectus muscles.
The disease code in ICD-10 is M 62.
Diastasis of the rectus muscles develops in 25% of cases in women who have carried more than one child. Often the disease is diagnosed during pregnancy, in the 3rd trimester or after a cesarean section. Middle-aged and older men who are obese are susceptible to this disease.
Diastasis in men most often occurs in the upper abdomen, and in women in the middle or lower abdomen.
https://youtu.be/Onb-aIL1pck
Causes of a protruding belly in women
There are many factors that lead to figure problems. However, the reasons for the formation of a bulging abdomen are not always obvious.
Organ disproportion
Even thin girls can have a protruding belly. The presence of such a problem is associated with a lack or excess of fat deposits on the internal organs. Normally, they protect the vital systems of the human body from external damage. Visceral fat also reduces the negative effects of heat and cold on internal organs. It is a backup power source.
Normally, the amount of visceral fat in the human body is 10-15% of total weight. To determine this parameter, you need to measure your waist circumference. The normal value is 88-89 cm for women and 95-100 cm for men.
Muscle weakness
Abdominal muscles
Women often have a protruding lower abdomen after pregnancy. But such a problem can occur in nulliparous girls or men.
The reason for abdominal protrusion is that the abdominal muscles have lost their natural tone. As a result, they do not hold the internal organs in their normal position.
Age-related changes
As we age, all women can experience a protruding belly. Because after 40-45 years, the hormonal levels of the fair sex change significantly.
With the onset of menopause, women's ovaries sharply reduce the intensity of estrogen production. However, the amount of testosterone remains the same. This leads to the appearance of a protruding abdomen in a male pattern.
Diastasis
The formation of diastasis is promoted by congenital weakness of connective tissue (dysplasia)
This is a pathology characterized by divergence of the rectus abdominis muscles. Diastasis occurs in pregnant women and in people who subject the abdominal wall to increased stress.
To check for a defect, you need to lie on your back, bend your knees and fix your feet on the floor. Fingers should be placed on the white line of the abdomen, slightly above the navel. Raising your head above the floor, you should determine the degree of divergence of the rectus muscles.
Digestive system problems
One of the possible causes of a protruding belly is a distended stomach.
A bulging abdomen in the lower part occurs in the presence of the following disorders:
- Distended stomach. The stomach will definitely bulge if you constantly eat large portions.
- Bloating. The lower abdomen can protrude when eating large amounts of gas-forming foods - confectionery and flour products, cabbage, legumes, carbonated drinks.
- Constipation. Such a problem worsens a person’s general well-being and causes a protruding belly.
- Inflammatory processes in the gastrointestinal tract. The problem may be localized in the intestines, liver, or gall bladder.
A poor state of the body, accompanied by bloating, can also be observed when following a diet. When consuming excessive amounts of vegetables, fruits and other healthy foods, the functioning of the gastrointestinal tract is disrupted. Therefore, your daily diet should be balanced - this will bring more benefits in the process of losing weight.
Incorrect posture
Incorrect posture visually enlarges the belly
With a curved spine, a negative effect such as a protruding stomach is observed. To check for problems with posture, you need to take a standing position with your shoulders, feet and head leaning against a flat surface. If a palm passes between the lower back and the wall, then there is cause for concern.
Gynecological problems
The appearance of a protruding belly can be caused by some women's health problems:
- endometriosis;
- formation of the uterus, ovaries;
- fibrosis and others.
Such disorders are accompanied by pain, disruption of the menstrual cycle, and heavy bleeding during menstruation.
Impact of stress
When stressed, the hormone cortisol is produced, which provokes the deposition of visceral fat.
If a person is in a difficult emotional state, his body releases a large amount of cortisol. This hormone helps sugar enter the bloodstream, which gives the body energy to save itself. A similar mechanism is genetically inherent in humans.
Under the influence of stress, fatty tissue actively increases, especially in the abdominal area. This problem also appears with a lack of sleep, an intense rhythm of life, in the absence of rest and an optimal daily routine.
Hormonal problems
The development of endocrine diseases is indicated by sudden weight gain, poor health and disruption of the functioning of internal organs. The most common cause of hormone imbalance is thyroid pathology.
In hypothyroidism, there is a decrease in thyroxine secretion. This hormone controls the process of burning fat in the human body.
Stages
Diastasis is divided into 3 stages:
- First. At this stage, the muscles diverge by no more than 5 cm. The usual shape of the abdomen is preserved and the disease is asymptomatic.
- Second. The discrepancy of the muscles can reach 10 cm. The abdomen protrudes, the waist flattens, and the patient begins to complain of pain when walking and physical activity.
- Third. At this stage, the connective tissue stretches along the entire vertical line by more than 10 cm. The patient has problems with posture and prolapse of organs.
Plastic surgeons also divide diastasis into several forms, taking into account the condition of not only the rectus abdominis, but also other groups of abdominal muscles. They distinguish the following types:
- A (occurs after childbirth);
- B (accompanied by relaxation of the lower and lateral sections);
- C (extends to costal arches and xiphoid process);
- D (diastasis combined with poor waistline).
Violation of the technique of performing abdominal exercises
Most believe that the classic exercise, known to everyone since school days, is quite enough to pump up the abs. But this is a misconception! By performing the same complex, you load only certain muscles.
Therefore, the stomach may not look the way you would like. To achieve your goal, vary your exercise program. This will be more interesting for you and more useful for the press.
For example, one of the best exercises for the abdominal muscles is the plank. Squats with dumbbells or a barbell, lunges and even running also bring good results.
Don't focus on one area, use general strengthening exercises.
For example, such as:
- twisting,
- leg lift while lying on your back,
- running with shin lashing,
- body rotations from sitting and standing positions,
- "bike".
That is, it is necessary to develop a whole set of exercises aimed at different muscle groups.
Causes
The main reason for the development of this disease is pregnancy. The growth of the uterus leads to severe stretching of the abdominal walls and an increase in abdominal pressure. Most often, diastasis develops during multiple pregnancies and when carrying a large child.
Among other causes of the disease in men and women, it is worth highlighting:
- obesity and rapid weight loss;
- heavy physical activity;
- chronic constipation and hemorrhoids;
- diseases of the respiratory system, accompanied by a severe cough;
- congenital connective tissue dysplasia;
- myopathy;
- HIV infection;
- scoliosis;
- varicose veins;
- flat feet with valgus deformity.
Why does a saggy belly appear?
There are several reasons why your belly hangs. Each of them is always based on an imbalance of the three most important factors of skin elasticity. These include:
- Abdominal muscle tone;
- Skin elasticity;
- The thickness of the fat layer.
Causes of a saggy belly
If any of the factors deviates from the norm, the stomach begins to sag. This definitely does not flatter your figure, forcing you to give up your usual clothes and relax on a crowded beach. Before you figure out how to remove a sagging belly, you need to understand what exactly led to the problem.
https://www.youtube.com/watch?v=n5sTUoG2eOs
Specific causes of sagging belly are:
- Thickening of the fat layer. Adipose tissue is similar in structure to a cellular mesh. Its cells have the ability to increase in size 60 times. At the same time, the skin in problem areas (abdomen, thighs, buttocks) becomes flabby and sags. This effect can be caused by poor nutrition, lack of physical activity, frequent stress, and hormonal imbalance.
- Consequences of pregnancy. The developing fetus puts pressure from the inside on the muscles and skin of the abdomen. After childbirth, body tissues do not acquire the necessary tone, remaining sagging. If a woman takes proper care of her skin and endures moderate physical activity, the skin should not sag much after childbirth.
- Dramatic weight loss. Overweight people often mistakenly believe that by getting rid of excess fat, they will immediately become the owners of a spectacular, toned figure. However, even if you “drive” fat from problem areas of the body, sagging skin will remain on them, especially in cases of sudden weight loss.
- Aging. With age, the skin loses its tone. This applies to the entire body, including the abdominal area. Even in slim people, as they approach old age, the skin becomes flabby and the stomach becomes saggy.
- Poor development of abdominal muscles. People who spend little time on physical activity often suffer from problems such as a sagging stomach and loose skin on the thighs. From an aesthetic point of view, even a thin person with such shortcomings looks unattractive. This is all due to too little load on the muscles and their poor development.
On a note. Sagging skin on the abdomen is often accompanied by stretch marks and cellulite, which also do not add attractiveness to the body. When taking measures to tighten the problem area, it is worth taking care of the skin.
Symptoms and external manifestations
Protrusion of the abdomen with diastasis
Initially, diastasis in men and women is practically asymptomatic. Some girls notice only external changes in the abdomen (it protrudes a little). Over time, a person, regardless of gender, begins to be bothered by painful sensations of varying intensity. Most often they appear after long walks, lifting weights and playing sports in the area of abdominal protrusion.
Protrusion of the navel with diastasis in women
Women, long after childbirth, may notice a strong protrusion of the navel and sagging abdomen.
Patients are often bothered by the following symptoms:
- feeling of discomfort and heaviness in the abdomen;
- constipation;
- belching.
Diagnostics
Diastasis can be diagnosed at home using a simple test. You will need to perform the following manipulations:
- Lie on your back.
- Bend your knees and press your feet to the floor.
- Place one hand under your head and the other on your stomach so that your fingertips are perpendicular to the white line in the navel area;
- Relax your stomach and lightly press on it with your fingers.
- Raise your shoulders and chest off the floor.
- Move your fingertips along the linea alba and feel the edges of the rectus muscles, determining the degree of their divergence.
To confirm the diagnosis, it is recommended to consult a doctor .
As a rule, the specialist performs only a visual examination of the abdomen, but may additionally prescribe an ultrasound and CT scan of the abdominal cavity.
Gas belly
If reduced or zero tone predominates in the gastrointestinal tract, then the sluggish cavities are filled with an increased amount of content. Transportation of chyme slows down significantly, it is not mixed enough and partially decomposes. When eating predominantly plant foods, fermentation occurs in the intestines. And then it is possible that the entire body can be poisoned by alcohol and other toxic substances released as a result. The resulting fermentation gases (nitrogen, carbon dioxide, oxygen of bacterial origin, methane) swell the intestinal loops and can lead to severe protrusion of the abdomen.
In the process of forming a gas belly, the grooves that highlight the relief of the abdomen first disappear. The abdominal cavity then expands, the abdomen protrudes forward to form a vault, which extends further outward in the upper abdomen as light gases rush upward, carrying the intestines with them. The position of the diaphragm reflexively increases, the sternum deviates, and a compensatory change in posture occurs. These are signs of a gassy stomach that has begun. Later, an ovoid gas belly appears and in the final stage a spherical gas belly appears.
From the pressure of gases, the stomach becomes like a tightly stretched drum, which gives rise to various ailments, including gas colic.
In a standing position, gases push out a person's upper abdomen, pressing towards the diaphragm and heart. This can cause gastrocardiac syndrome with its various manifestations - pressure and pain in the heart or behind the sternum, palpitations, changes in heart rate, dizziness, etc.
Fecal, gas and fat bellies ==>>
Tags: Men's health
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Treatment methods
Treatment of diastasis is carried out at home. The patient is required to regularly perform special exercises and follow the general recommendations of the specialist. They often resort to taping. Surgical intervention is required for the third degree of diastasis.
Recommendations for lifestyle when treating this disease:
- limit physical activity;
- do not lift heavy objects;
- Avoid performing abdominal exercises, straight-legged push-ups and strength training.
Physical exercise
It is advisable to perform the exercises daily for 20 days. It is advisable to conduct a diastasis test once every 2 weeks to be aware of changes. The following simple exercises are most effective for this disease:
| Name | Performing the exercise | Photo |
| Knee extension to the sides |
| |
| Bridge |
| |
| Side plank |
|
It is recommended to repeat each exercise 5 times. This complex is suitable not only for the treatment of diastasis, but also for its prevention.
Taping
Taping in combination with physical exercise promotes complete tissue restoration. Tape is a cotton tape with an adhesive base, which is as close as possible in its elastic characteristics to human skin. It not only supports damaged abdominal muscles, but also improves blood circulation and relieves pain.
Taping of the rectus muscles is carried out in the supine position. The tape is applied along the width of the gap and worn for about a week. The tape material is resistant to liquids, which allows you to take water procedures. Depending on the severity of the disease, taping is repeated until the patient recovers completely.
Surgery
There are several methods to cure diastasis:
- Use of an endoprosthesis. This surgical method is considered one of the most effective. During the operation, the specialist makes a small incision near the navel or punctures and installs a multilayer mesh.
- Hernioplasty. During the procedure, the surgeon makes 3 small punctures and inserts special manipulators with a video camera inside, which helps monitor the progress of the operation. Hernioplasty helps eliminate diastasis and shape the waist. There are no visible scars or pain after surgery, and the rehabilitation period is reduced to 10 days.
For women, the operation is performed no earlier than a year after the birth of the child and if the abdominal muscles are in normal condition. After surgery, it is not recommended to plan pregnancy until complete recovery.
Ways to deal with a protruding belly
Abdominal training with abdominal vacuum
If you have problems with your figure, you need to change your eating habits. You should eat in portions, including a sufficient amount of proteins, fats and carbohydrates in your diet. We must not forget about the optimal drinking regime.
Special exercises have been developed against a sagging belly. Vacuum is one of the most effective. It is recommended to do the exercise on an empty stomach, preferably after waking up. You need to stand straight, relax your body, inhale and exhale sharply. In this case, you should pull in your stomach as much as possible and stay in this position for 15 seconds. The exercise is repeated 3-5 times daily.
To improve the appearance of your abdomen, it is also recommended to exercise your abs regularly. To tighten the oblique muscles on the right and left, you need to lift the body with a turn in a certain direction. It is also useful to hula hoop, run, and subject your body to standard cardio and strength training.
In the fight for a slim figure, experts recommend additionally using massage, doing body wraps, using masks, creams, and scrubs. It is not advisable to carry out such procedures at home yourself; it can harm your health. It is better to seek help from specialists.
https://youtu.be/oxQZivgKwS4
Possible complications
In the second and third stages of diastasis, the risk of developing a hernia increases, which is one of the most common and severe complications in both men and women. In this case, the patient is indicated for surgical intervention and long-term rehabilitation.
Another common complication of diastasis is organ prolapse (splanchnoptosis). The disease is manifested by tachycardia, nausea and chronic constipation, which can lead to intestinal obstruction in the absence of medical attention.
With diastasis, there is an increased load on the spine, which can lead to the formation of an intervertebral hernia.
Causes of “lost belly”
Reason No. 1. Disorders in the digestive system.
Cholecystitis, pancreatitis and other diseases inevitably lead to the fact that the stomach begins to bulge in the front. This is due to the fact that in places of the pathological organ: intra-abdominal pressure changes; adhesions are formed. If you don’t deal with them, then neither sports nor diet will help - your stomach will continue to bulge.⠀ ⠀
Reason No. 2. Lordosis (when the lower back has a strong arch).⠀
In this case, the vertebrae become very close to each other, the nerve endings and blood vessels are pinched. Meanwhile, blood circulation to all internal organs comes from the spine. If there are violations, the abdominal wall begins to protrude.⠀
Reason No. 3. Weakness of the pelvic muscles.
When a person tucks his buttocks under himself, and his pelvis seems to fall forward. This story is fraught not only with a “lost” belly, but also with prolapse of internal organs. In this case, you need to work with the gluteal and internal pelvic muscles to eliminate the pathological problem. Most often, such defects require complex treatment and exercises alone are not enough.⠀
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Reason No. 4. Asymmetry of the left and right sides.
In this situation, unilateral prolapse of internal organs and even unilateral inflammatory processes may occur. This is fraught with weakness of the pelvic muscles and, as a result, “prolapse” of the abdomen. ⠀
Prevention
To avoid the occurrence of the disease, you should adhere to general recommendations:
- do not lift heavy objects;
- add fiber to your diet to avoid chronic constipation;
- undergo examination at the clinic (preferably once a year);
- control body weight.
Some people, regardless of gender, have a hereditary predisposition to diastasis and weak abdominal muscles from birth. In such cases, it is especially important to exercise regularly to help prevent the development of the disease. Doing special exercises is also useful during pregnancy, since it reduces the risk of postpartum diastasis by 35%.
Diastasis at an early stage goes away in about 2-3 months without any intervention from surgeons, subject to all recommendations of the attending physician and regular performance of special exercises. In any case, the prognosis is favorable if you consult a specialist in a timely manner. Prevention will help to avoid the occurrence of postpartum diastasis, which should be started even during pregnancy planning.
What causes bloating?
That puffy, puffy belly you hate so much is usually caused by one of three things:
1.Too much fat
What many people think of as sagging skin is simply body fat that contributes to bloating. In fact, in our experience of working with thousands of people, we have found that when people complain of chronic bloating, the real problem is excess fat. Luckily, it's not hard to tell the difference between bloating and excess fat.
2. Bloating comes and goes
You may wake up with a flat stomach and look like a pregnant woman by the time you go to bed. On the other hand, belly fat doesn't change much unless you overeat or undereat. If you measured your waist at your navel every morning and night, you would see it clearly. If bloating is the culprit for the increase, readings will vary widely. However, if fat is the culprit, the results will be consistent.
3.You can't gain a lot of fat suddenly.
When you gain fat, it is not as noticeable as bloating. If you decide that the problem with abdominal enlargement is really excess fat, and not bloating, read this article to solve this problem.
Lactose intolerance
Research shows that approximately 70% of the world's population cannot properly digest lactose, which is a sugar found in dairy products. The reason for this is that the intestines are unable to produce enough of an enzyme called lactase, which is needed to completely digest lactose. Undigested lactose passes through the small intestine without absorption, and when it reaches the large intestine, bacteria eat it and produce gas as a byproduct. This expansion in the colon creates a swollen, bloated abdomen, and often causes diarrhea.
Imbalance of sodium and potassium
If your body receives sodium above normal, your body will retain water and you will see this most clearly in your skin. A relatively small increase in water content under the skin causes the skin to appear noticeably softer and thicker.
Many people don't realize how easy it is to increase their sodium intake themselves, which can cause problems with belly fat. One teaspoon of table salt contains about 2.3 grams of sodium (that's the upper daily limit recommended by the Institute of Medicine), and all it takes is a couple extra teaspoons above your normal intake to noticeably increase bloating.
This is why you often wake up with a bloated belly after a good meal at your favorite restaurant. One of the rules of good cooking is that most dishes should be salted as much as possible to bring out the flavors.
Many people consume too many dietary supplements such as salt every day, and in such cases, to get rid of bloating, you just need to control the amount. (We'll talk about this later.)
Hormonal disorders
Hormones are the scapegoat. Have you gained weight? Don't listen to those who accuse you of overeating. It's your hormones and it's not your fault! Can't lose weight? You probably just have a slow metabolism caused by evil hormones conspiring against you. Can't suppress your appetite? Willpower has nothing to do with this! Hormones are to blame for everything! Did you guess right?
Scammers love to talk about hormones because a little pseudoscientific bullshit is all it takes to convince people to buy what they're selling. So when someone claims that hormones are responsible for poor health, you should be really skeptical.
The reality is, if you're struggling with common issues like plateaued weight loss, slow muscle growth, or unsightly belly fat, your hormones are probably fine. You just need to learn and apply the basics.
However, when it comes to bloating and water retention, hormones can have a noticeable effect. The best demonstration of this that I know of is an experiment conducted during World War II that would not be possible today for ethical reasons.
Led by Dr. Ansel-Keys, it was known as the “Minnesota Famine Experiment,” and its goal was to study the physical and psychological effects of fasting and create an effective regimen to help starving prisoners of war resume normal eating patterns and metabolic functions.
The experiment involved 36 volunteers (military protesters who chose the experiment to avoid being sent overseas) and began with 12 weeks of daily hard work and a diet of approximately 3,200 calories. Then came the next 6-month stage of the investigation, which was called “hand to mouth,” and consisted of cutting calorie intake in half, to about 1,500 calories while maintaining a physical work routine.
The researchers adjusted each person's diet along the way, with the goal of achieving a 25% reduction in body weight by the end of the 6-month period. After the fasting period, there was 20 weeks of “metabolic rehabilitation,” which consisted of limited and unrestricted increases in caloric intake.
There's a lot of fascinating information in the published research results, but I want to highlight one observation in particular here. At the beginning of the experiment, the men typically lost weight in a predictable and linear manner, about 1 kilogram each week.
After a while, however, the weight loss became strangely non-linear. Nothing could change on the scales for weeks, and literally overnight “spikes” of weight loss occurred: men became 1-2 kilograms lighter than the day before. The researchers found that they observed the effects of dramatic increases and decreases in water retention. In the bodybuilding world this is known as the “whoosh effect.” That is, men did lose fat in those weeks when weight did not change, but it was offset by equal or greater amounts of water retention. Now you're probably wondering what triggered the whistling sound in the test subjects. Well, some happened by chance, but scientists have found that they are most often accompanied by a sharp increase in calorie intake.
For example, halfway through the experiment, a meal of 2,300 calories was observed. Scientists noticed that many of the men woke up several times during the night to pee and were several kilograms lighter the next morning.
So what's going on here? What caused men's bodies to retain large amounts of water and why did eating large amounts of food change this?
Well, the main culprit was the hormone cortisol .
Research shows that a long-term calorie deficit dramatically increases cortisol levels. This causes many unwanted effects in the body, including increased water retention.
Increased cortisol levels, as well as increased water intake, can make your body look bloated.
So you'd expect a significant decrease in cortisol levels to create the opposite effect, right? This is exactly what happened to the patients of the Minnesota experiment. The holiday, which caused an increase in calorie intake, significantly reduced cortisol levels, which in turn caused a rapid expulsion of water.
This is why a “recovery day” often results in weight (water) loss.
So, bringing this back to the topic at hand, the point is this. If your cortisol levels are chronically elevated, you will have problems with a big belly.
