Why is diastasis recti not mentioned when referring to obesity and girth?
—Kenneth R. Kaisch, MD, San Antonio

Diastasis recti refers to thinning of the linea alba in the epigastric area, resulting in a midline vertical abdominal bulge that is frequently misperceived by patients to be a hernia. What is most significant about diastasis recti is its benign nature. It is not a hernia since the transverse fascia is intact and thus does not carry a risk of intestinal strangulation. As might be expected, this acquired weakening of the linea alba is exacerbated by abdominal obesity. It is important to reassure patients that diastasis recti is benign and to counsel them on weight loss as a way to improve it. Surgical repair is not indicated, though it is sometimes done in the context of abdominoplasties.
—Susan Kashaf, MD, MPH (120-6)