The Stitch

Abdominal Bulging: Diastasis Recti or Hernia?

The main way to tell if you have a hernia or diastasis recti is whether you feel pain. Hernias can cause substantial pain while diastasis recti may increase discomfort and abdominal wall weakness.

Let’s take a deeper look into the difference between diastasis recti and hernias.

A person wearing jeans and a sweater is doubled over in pain, clutching their stomach.Diastasis recti

Diastasis recti happens when the connective tissue between your rectus abdominis (six-pack) muscles is stretched, creating an abnormally wide distance between the muscles. This separation can present as a bulge, usually of the upper abdomen, that you may notice when you cough, sit up in bed or lift something heavy.

The most common causes of diastasis recti are pregnancy and obesity, but abdominal wall weakness and previous abdominal surgery can also increase a person’s risk. Diastasis can also be congenital or something that developed in the womb.

Typically, diastasis recti are oval-shaped bulges between the breastbone and belly button and are not painful. A person may notice it during activities that cause them to contract the abdomen.

Aside from the prominent bulge, abdominal wall weakness could make any type of weightlifting and core exercises more difficult.

A doctor may diagnose diastasis recti when they see a “classic bulge” present when the patient sits up. A CT scan showing a separation of ab muscles may also lead to a diagnosis.

Diastasis often does not require surgery. For pregnant people, the condition typically improves after childbirth.

Following diagnosis, prescribed treatment may involve physical therapy to strengthen the ab muscles or diet and exercise for weight loss purposes.

If abdominal wall weakness associated with the diastasis recti becomes problematic, an abdominal binder may help. There are many types of abdominal binders; however, the general concept is a compressive garment worn around the belly to provide additional support.


A hernia is a hole in the tissues of the belly wall through which fat, fluid or an organ can stick out. Hernias can be located at or near the bellybutton, in the groin, or at a previous surgical incision. Some hernias are present at birth while others develop over time.

A hernia looks like a bulge or protrusion located somewhere on the abdomen or in the groin. You may notice the hernia when you cough, sneeze, lift a heavy item or during a bowel movement. The bulge can be visible during rest periods, as well.

Hernias will often cause pain at the site of the bulge.

A hernia can often be diagnosed during an exam; a doctor may be able to see or feel the hernia’s bulge or they will use a CT scan for a better look at the abdominal wall to determine if there is a hole.

Hernias can be repaired surgically, and the goal is to repair them before tissue or a stomach intestine pushes through the hole.

Abdominal binders are recommended for hernias, as well, to reduce symptoms.

If you would like a doctor to look at your abdominal bulge, call (713) 798-6363 to make an appointment at the Baylor Medicine Hernia Center.

By Heather West, PA-C, Specialty Abdominal Wall Surgery, Division of Trauma and Acute Care Surgery

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