A bulge along the front of your abdomen can be concerning, especially when it becomes more noticeable when you exercise, cough, or sit up. Two common causes of abnormal bulging are diastasis recti and a ventral hernia. The conditions may look similar and can sometimes occur together, but they’re different and require different treatment approaches.
New York Hernia Center specializes in advanced hernia surgery, including ventral hernias.
Daniel Rosen, MD, and our surgical team use the latest laparoscopic techniques to repair the hernia and reinforce weakened tissue so the hernia doesn’t recur.
Diastasis recti is a widening of the connective tissue between the left and right rectus abdominis muscles, commonly known as the “six-pack” muscles. The muscles move apart, but no true hole or defect forms in the abdominal wall.
This condition is common during and after pregnancy because the abdominal wall stretches as a woman’s uterus grows. Diastasis recti can also affect men and women following weight changes, and because of aging or repetitive abdominal strain.
Diastasis recti might create a ridge or dome down the middle of the abdomen when you sit up, cough, or tighten your core. Some people experience other symptoms like:
However, bowel or fatty tissue doesn’t become trapped through an opening.
A ventral hernia develops when there’s an actual weakness or opening in the abdominal wall. Fatty tissue, intestine, or other abdominal contents can push through the defect and form a visible or palpable bulge.
Ventral hernias can develop in several locations:
The bulge may become larger with standing, lifting, coughing, or straining. Depending on its size and contents, a ventral hernia can cause pressure, aching, tenderness, or sharp abdominal pain.
The main difference between a ventral hernia and diastasis recti is the abdominal wall itself.
With diastasis recti, the connective tissue is stretched, and the muscles are separated, but the wall remains intact. With a ventral hernia, a defined defect allows tissue to protrude through the abdominal wall.
Because both conditions can cause a midline bulge, it’s important to get a proper diagnosis. Dr. Rosen typically identifies the cause of symptoms through your medical history and an examination.
You might need an ultrasound or a CT scan to determine if one or both conditions are present.
Nonsurgical care is generally the first step in treating diastasis recti. A physical therapist or rehabilitation professional may recommend exercises that improve deep-core coordination, breathing mechanics, and abdominal wall function.
You may need to modify movements that cause pronounced bulging or excessive pressure on your midsection.
Surgery may be an option when tissue separation is severe, symptoms persist despite rehabilitation, or diastasis recti occurs along with a true hernia.
Exercise can improve your core strength, but it won’t close a true hernia. Hernia surgery is the most effective way to repair a ventral hernia.
Depending on the hernia’s size, location, your symptoms, and surgical history, Dr. Rosen can use an open, laparoscopic, or robotic approach. They can reinforce the abdominal wall with a medical-grade mesh when appropriate.
Not every ventral hernia requires emergency surgery, but you should still get evaluated. Seek urgent medical attention for sudden, severe pain, vomiting, or a bulge that becomes firm, very tender, or difficult to push back in.
These symptoms may indicate trapped or compromised tissue, which can be a life-threatening situation if left untreated.
If you have an abdominal bulge, persistent discomfort, or concerns about core weakness, an accurate diagnosis is the first step.
Dr. Rosen and our New York Hernia Center team provide individualized evaluations and advanced treatment options, including minimally invasive and robotic hernia surgery.
Call the New York Hernia Center office in the Upper East Side of Manhattan, New York, today to schedule a consultation, or book an appointment online to learn more about your treatment options for a ventral hernia.
