Hi Joey,

I'm a physio with experience in musculoskeletal and women's health. What you're describing sounds like a classic case of abdominal diastasis, common name 'tenting' (from the shape you see when you do a sit-up! It's caused almost always by pregnancy,a nd happens to about 70% of women in late pregnancy, but to different degrees. If you've still go that level of separation 16 months after the birth of your last baby, you were probably at the more severe end of the scale. It's also more commonly worse in women who have babies close in age one after the other, and more so if you don't work really hard to restore good abdominal muscle strength in between babies. What happens is that as your belly gets bigger, the abdominal muscles don't have enough sideways stretch to get around the bump, so they separate in a vertical line straight down the middle of your belly, sometimes just above the belly button, sometimes below as well. After baby is born, retraining your abs to work helps the separated edges to come closer together - they never actually 'fuse' or heal together again, but the edges lie close enough to each other that it make no difference. If your abs never really get retrained after pregnancy, the separation remains, and when you try to use them (such as in a sit up) they stay separated, and allow the mass of internal organs to bulge between them.

I would have thought that a colo-rectal surgeon would have been familiar with this fairly common problem... though, to be fair, it's not so common to still be a problem 16 months after the birth of baby.

Ask your GP for a referral to a Women's Health Physiotherapist (you'll need a referral to go public, but if you are in a financial position to do so, you can 'self-refer' to a private women's health physio - just give them a call,) as the first step is to use conservative (ie, non-surgical) measures to try and improve your abdominal function. Basically that means exercises, but it's really important that you do the right exercises in the right way to help the edges of the muscles come together, If you do lots of situps, it can potentially make things worse, and at the very least, puts you at risk of injuring your low back through doing repeated flexion movements with the support of strong abs.

It sounds like you're really keen to do something about this, and in almost every case that I've treated (over 15 years) the right exercises make a massive difference over time.

I understand that the surgical solution is also very successful, but is a major operation, done under GA, leaving significant scarring, usually, and is not to be taken lightly, and any good surgeon would insist that you spend time and effort on exercise first. The surgery, if you eventually needed it, would probably be the domain of a plastic surgeon.

I hope that helps.