Diastasis recti abdominis (DRA): review of risk factors, diagnostic methods, conservative and surgical treatment
Diastasis recti abdominis (DRA) is an acquired condition defined as a thinning, widening and protruding of the linea alba following an increase in intra-abdominal pressure. The aim of this review is to provide insight in the pathophysiology, risk factors, diagnostic methods and treatment modalities...
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IMR Press
2022-05-01
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| Series: | Clinical and Experimental Obstetrics & Gynecology |
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| Online Access: | https://www.imrpress.com/journal/CEOG/49/5/10.31083/j.ceog4905111 |
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| author | Leszek Sułkowski Andrzej Matyja Czesław Osuch Maciej Matyja |
| author_facet | Leszek Sułkowski Andrzej Matyja Czesław Osuch Maciej Matyja |
| author_sort | Leszek Sułkowski |
| collection | DOAJ |
| description | Diastasis recti abdominis (DRA) is an acquired condition defined as a thinning, widening and protruding of the linea alba following an increase in intra-abdominal pressure. The aim of this review is to provide insight in the pathophysiology, risk factors, diagnostic methods and treatment modalities of DRA. DRA occurs in both women and in men, however, it is extraordinarily common and even expected condition affecting over half of women during pregnancy and one third 12 months after childbirth. There is no consensus of risk factors for DRA. Proposed risk factors include multiparity, maternal age and high age, caesarean section, macrosomia, multiple pregnancy, ethnicity, heavy lifting, body mass index (BMI) and diabetes. To diagnose the presence of DRA and its severity the interrecti distance (IRD) is measured. Palpation, caliper, ultrasound, computed tomography (CT) and magnetic resonance (MR) are applied to measure IRD and exclude concurrent hernias. DRA is mostly treated conservatively by physiotherapists. However, physiotherapy is unlikely to prevent or completely treat DRA. Over four fifth of patients are unsatisfied with the results of training programmes and opted for surgical intervention. Thereby the main purpose of physical training is to restore function, not to reduce the DRA. Physiotherapy may be an alternative for those who cannot undergo surgery. In case if severe cosmetic and functional impairment patients are referred for surgery. Patients with severe symptoms benefit more from surgery. Surgery is challenging since guidelines almost do not exist. Plication and mesh reinforcement are recommended by most authors, however whether it should be open or laparoscopic remains debatable. |
| format | Article |
| id | doaj-art-fb38610baa4d4c709b6cf8efc731b1ce |
| institution | Kabale University |
| issn | 0390-6663 |
| language | English |
| publishDate | 2022-05-01 |
| publisher | IMR Press |
| record_format | Article |
| series | Clinical and Experimental Obstetrics & Gynecology |
| spelling | doaj-art-fb38610baa4d4c709b6cf8efc731b1ce2025-08-20T03:48:31ZengIMR PressClinical and Experimental Obstetrics & Gynecology0390-66632022-05-0149511110.31083/j.ceog4905111S0390-6663(22)01771-7Diastasis recti abdominis (DRA): review of risk factors, diagnostic methods, conservative and surgical treatmentLeszek Sułkowski0Andrzej Matyja1Czesław Osuch2Maciej Matyja3Department of General Surgery, Regional Specialist Hospital, 42-218 Częstochowa, PolandDepartment of General, Oncologic, Metabolic and Emergency Surgery, Jagiellonian University Medical College, 31-109 Kraków, PolandDepartment of General, Oncologic, Metabolic and Emergency Surgery, Jagiellonian University Medical College, 31-109 Kraków, PolandDepartment of General, Oncologic, Metabolic and Emergency Surgery, Jagiellonian University Medical College, 31-109 Kraków, PolandDiastasis recti abdominis (DRA) is an acquired condition defined as a thinning, widening and protruding of the linea alba following an increase in intra-abdominal pressure. The aim of this review is to provide insight in the pathophysiology, risk factors, diagnostic methods and treatment modalities of DRA. DRA occurs in both women and in men, however, it is extraordinarily common and even expected condition affecting over half of women during pregnancy and one third 12 months after childbirth. There is no consensus of risk factors for DRA. Proposed risk factors include multiparity, maternal age and high age, caesarean section, macrosomia, multiple pregnancy, ethnicity, heavy lifting, body mass index (BMI) and diabetes. To diagnose the presence of DRA and its severity the interrecti distance (IRD) is measured. Palpation, caliper, ultrasound, computed tomography (CT) and magnetic resonance (MR) are applied to measure IRD and exclude concurrent hernias. DRA is mostly treated conservatively by physiotherapists. However, physiotherapy is unlikely to prevent or completely treat DRA. Over four fifth of patients are unsatisfied with the results of training programmes and opted for surgical intervention. Thereby the main purpose of physical training is to restore function, not to reduce the DRA. Physiotherapy may be an alternative for those who cannot undergo surgery. In case if severe cosmetic and functional impairment patients are referred for surgery. Patients with severe symptoms benefit more from surgery. Surgery is challenging since guidelines almost do not exist. Plication and mesh reinforcement are recommended by most authors, however whether it should be open or laparoscopic remains debatable.https://www.imrpress.com/journal/CEOG/49/5/10.31083/j.ceog4905111diastasis recti abdominis (dra)physiotherapysurgeryabdominal wall reconstructionmidline reconstructionmidline plicationabdominoplasty |
| spellingShingle | Leszek Sułkowski Andrzej Matyja Czesław Osuch Maciej Matyja Diastasis recti abdominis (DRA): review of risk factors, diagnostic methods, conservative and surgical treatment Clinical and Experimental Obstetrics & Gynecology diastasis recti abdominis (dra) physiotherapy surgery abdominal wall reconstruction midline reconstruction midline plication abdominoplasty |
| title | Diastasis recti abdominis (DRA): review of risk factors, diagnostic methods, conservative and surgical treatment |
| title_full | Diastasis recti abdominis (DRA): review of risk factors, diagnostic methods, conservative and surgical treatment |
| title_fullStr | Diastasis recti abdominis (DRA): review of risk factors, diagnostic methods, conservative and surgical treatment |
| title_full_unstemmed | Diastasis recti abdominis (DRA): review of risk factors, diagnostic methods, conservative and surgical treatment |
| title_short | Diastasis recti abdominis (DRA): review of risk factors, diagnostic methods, conservative and surgical treatment |
| title_sort | diastasis recti abdominis dra review of risk factors diagnostic methods conservative and surgical treatment |
| topic | diastasis recti abdominis (dra) physiotherapy surgery abdominal wall reconstruction midline reconstruction midline plication abdominoplasty |
| url | https://www.imrpress.com/journal/CEOG/49/5/10.31083/j.ceog4905111 |
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