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Dr. Andrew Rynne

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Diagnosed with umbilical hernia with divarication of rectus muscles. Is this curable?

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Dr. Grzegorz Stanko

General Surgeon

Practicing since :2008

Answered : 5770 Questions

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Posted on Tue, 5 Feb 2013 in Medicines and Side Effects
Question: I had a C section 4months back. Now been diagnosed with umbilical hernia with divarification of rectus muscles.I have no pain due to this. Will it get better with time? Is it advisable to correct this, before I get pregnant again say after 3years? or it can be rectified during/after next baby birth if its also C section? Also let me know, if I can wear a belt? This belt, a doctor had earlier suggested me - can it help rectify this problem or its only for comfort and support? Also one other doctor had advised me to rectify this, after next baby birth and after family planning?
doctor
Answered by Dr. Grzegorz Stanko 3 hours later
Hello!

Thank you for the query.

The main problem with umbilical hernias is that the hole in the abdominal wall is small. It creates conditions for such hernia to stuck in such small hole. Usually it does not happen, however no one is able to tell yo if it will happen and when. Luckily, between the hernia and intestines, there is an omentum, free fatty tissue which covers intestines. And usually if something stuck in umbilical hernia, it is this fat only. It also gives symptoms so the patient can usually notice that something has happen.
What causes hernia worse and can give pain and let something to get through it is increased pressure in the abdominal cavity. It appears when you lift heavy weights, cough and push hard on stool. Increased abdominal pressure is also during the pregnancy. So pregnancy gives increased risk for such hernia to get worse. And there is nothing worse than urgent abdominal surgery during the pregnancy.
What I`m trying to say is that more reasonable is to get it fixed now, when you can schedule it and it wont cause any side effects for pregnancy than being forced to do that during the pregnancy. Umbilical hernia surgery is certainly small one, easy to perform, an incision is small and recovery time is quite fast.
You need to also know that the only way to fix this hernia is surgery. So it wont get better with time, and the belt wont fix it either. The belt is used only for your comfort and for hernia to not get bigger (as with the time it usually gets bigger).

So in conclusion, I would prefer to have such surgery now than during the pregnancy. Of course it is technically possible to have it fixed during the C-section.

Hope this will help. Feel free to ask further questions.
Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Grzegorz Stanko 15 hours later
Will having sexual intercourse increase this hernia? Say if I undergo surgery to fix this umbilical hernia after a few months from now, and after recovery, if I get pregnant again, I have heard that it can be recurrent in next pregnancy also. If it happens again, will I have to undergo one more surgery to get it fixed again? So fixing this during next C-section would be better then I think. what is your view on this? Will excercising/walking/jogging help in muscle toning to improve this divarification of rectus muscles? Can I do jogging/cycling for now? Rectus divarification and this umbilical hernia, can it be due to the C section I had 4months ago? If it was a vaginal delivery, can this still would have occurred to me? If the divarification reduces, will this umbilical hernia subside by itself?
doctor
Answered by Dr. Grzegorz Stanko 4 hours later
Hello!

Sexual intercourse does not affect this hernia.
You have mentioned that your next pregnancy is planned to be after about 3 years. And the complete healing after the hernia repair takes up to a year. In that time, all processes including tissues rebuild and scar tissue creation and remodeling will be done. This scar tissue is a solid base keeping the intestines in the right place. So if you do want to be pregnant in a few years, this hernia should not recur. But if you will do that quicker, than you are right, the hernia can recur.
During the pregnancy abdominal wall stretches due to tissues rebuilding. After the pregnancy this tissues do try to come back to the state from before the pregnancy. In other words, your abdominal wall shortens.
If you ask the doctors to fix your hernia during the C-section, it will be done with that stretched, weak tissues. This may become completely ineffective.
So it is better to do that either before next pregnancy, or some time after it.
If it is about your divarification, in some cases it can get reduced due to muscle strengthening. But mostly it does not. The treatment of it depends of the size of it. If it is small, like few centimeters, and does not give any symptoms, you should leave it alone and like you have said, try to improve your muscles so it can get reduced. Such divarification is something that needs mesh to be fixed and this one should not be done before the pregnancy (if does not bother you, no pain).
So what I would recommend you is umbilical hernia surgery now and strengthening your rectus muscle.
Every physical activity excluding those which do push your intestines out (like crunches) will improve this muscles. So jogging, cycling can do that.
C-section (if the incision where in the lower abdomen) has not caused your hernia and divarification and vaginal delivery would not make any difference. This divarification was gradually created by increasing abdomen due to pregnancy.
Hernia wont subside by itself, this is impossible. Divarification sometimes does, when small enough.

Hope I have answered all your questions. Feel free to ask further questions.
Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Grzegorz Stanko 39 hours later
Thanks for your elaborate response.
A few more questions.

Right now, I'm wearing a belt. Can wearing belt cause any side effect like back pain or possibility of worsening this hernia? Once back to work, being a software engineer demands sedentary type of work from 10am to 6pm. Is it ok to wear this belt continuously for so long? how long would u recommend wearing the belt daily?

Is there any specific exercise to strengthen muscles so as to reduce divarification?
doctor
Answered by Dr. Grzegorz Stanko 4 hours later
Hello!

The belt makes back muscles weaker so it is not advisable to wear it permanently. You should wear it during the physical activity and work witch can cause pushing your abdomen. If you sit a lot at work and your back rests on the backrest, the belt seems not necessary. So minimize wearing of this belt as much as possible.
The belt wont make your hernia worst. It should prevent it to develop.
The exercises which should make your muscles stronger are jogging or cycling. You should avoid those classic exercises which do make abdomen stronger and cause increased abdominal pressure during performing it (like crunches).

Hope this will help.
Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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