9 Causes of Pain Two Inches Above the Belly Button.

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what you need to know:

Pain 2 inches above your belly button can arise from:

  • The stomach and duodenum: chronic gastritis, peptic ulcer disease, functional dyspepsia, Gastroparesis, and gastric cancer.
  • The pancreas: as with chronic and acute pancreatitis.
  • The intestine and the colon: Irritable bowel syndrome, Inflammatory bowel diseases (such as chron’s and ulcerative colitis, Food intolerances, colon cancer, and others.
  • The Gallbladder: Gallstone diseases and cholecystitis.
  • The liver: as with acute and chronic hepatitis.
  • Abdominal wall: epigastric hernia and abdominal muscle strain.
  • Other rare causes include mesenteric lymphadenitis, aortic dissection, familial Mediterranean fever, abdominal migraine, and others.

The most common three causes of pain 2 inches above the belly button are:

  1. Functional dyspepsia (indigestion).
  2. Chronic gastritis.
  3. Stomach and duodenal ulcers.

1 . Functional dyspepsia (Indigestion).

Chronic indigestion (functional dyspepsia) is one of the most common functional diseases affecting your digestive system. It affects more than 20% of people (one out of every five people has functional dyspepsia.

Doctors define functional dyspepsia as the presence of epigastric (upper-middle) abdominal pain, burning, or discomfort with a sense of fullness.

When the symptoms are present without any diseases affecting your stomach, duodenum, or any part of your gut, it is called “Functional” or “Non-ulcer” dyspepsia (reference).

We don’t know the exact cause of functional dyspepsia; Theories include chronic stress, anxiety, Hidden gut infections, recent antibiotic use, and undiagnosed food intolerances.

Symptoms of functional dyspepsia:

  • Pain or discomfort in the middle of the stomach (2 to 4 inches above the belly button).
  • Early satiety soon after you start eating.
  • A sense of fullness in the upper-middle part of your abdomen after eating.
  • Epigastric (upper-middle abdomen) burning.
  • Bloating after eating.
  • Excessive bleching.
  • Nausea can also be present.

The above symptoms are non-specific and can occur with chronic gastritis. The differentiation without the help of your doctor is impossible.

2. Chronic gastritis and peptic ulcer disease.

Chronic gastritis is the inflammation of the lining of your stomach. It is a prevalent condition. Faulty diet habits, H. pylori infection, and Non-steroidal anti-inflammatory drug use are the most common causes (reference).

Chronic gastritis causes burning or gnawing pain in the upper central part of your abdomen (a few inches above your belly button.

As the chronic inflammation continues, a disruption in the lining of your stomach or duodenum develops. As a result, stomach and duodenal ulcers are often a result of gastritis.


  • Middle stomach pain a few inches above the belly button (epigastric area).
  • The character of pain: burning, gnawing, or dull aching continuous pain.
  • Triggered by: eating, particularly acidic, spicy foods and caffeinated drinks.
  • The pain is often associated with nausea or vomiting.
  • Fullness in the middle of the stomach after eating.
  • The pain often improves with anti-acid treatments such as antacids, H2 blockers (famotidine), or proton pump inhibitors (omeprazole).

When Ulcer develops, the symptoms can be the same or vary a little, For example:

  • With duodenal ulcers, You may get a temporary relief of pain when you eat. However, the pain worsens as time goes on (pain increases by fasting).
  • With stomach ulcers, Food will trigger the pain, while fasting improves your symptoms.
  • Bleeding can occur from both duodenal and stomach ulcers leading to vomiting of blood or passage of black tarry stool.
  • Signs of anemia (due to recurrent minimal bleeding) include dizziness, fast heartbeats, fainting, shortness of breath, etc.

3. Gastroparesis (slow stomach).

Gastroparesis occurs when your stomach takes more time to empty its contents. It is often due to the inability of your stomach to move and propel Food (slow stomach motility).


  • Unkown: about 50% of the cases of Gastroparesis are of unknown cause.
  • Diabetes mellitus: prolonged diabetes mellitus is a significant risk factor for Gastroparesis (Diabetes affects the nerves supplying your stomach).
  • Viral stomach infections (as norovirus and rotavirus). These viruses cause acute Gastroparesis.
  • Some medications: some antihypertensive medications, tricyclic antidepressants, Clonidine, some anti-diabetes drugs, and more.
  • After surgery: some abdominal and chest surgeries cause damage to the stomach nerve supply (the vagus nerve).
  • Some neurological diseases as multiple sclerosis (MS), brain stem stroke, and Parkinson’s disease.


  • E prolonged sense of fullness after eating.
  • Discomfort or stomach pain a few inches above the belly button.
  • Nausea (in 93% of the cases)
  • Vomiting (in up to 84%)
  • Early satiety (Up to 86%)
  • Fullness after meals, bloating.
  • Weight loss in severe cases.

Gastroparesis is one of the most common complications of diabetes. Suspect Gastroparesis if you have long-lasting diabetes and pain in the upper abdomen 2 inches above your belly abdomen.

Gastroparesis is diagnosed by a particular test that assesses the time your stomach takes to empty its contents. Learn More.

4. Gallbladder diseases.

Your gallbladder can cause pain above the belly button, either to the right side or in the middle of the stomach.

Causes of gallbladder pain:

  • A stone inside your gallbladder (gallstone).
  • Obstruction and inflammation of the gallbladder (acute cholecystitis).
  • Functional gallbladder disease.
  • A stone inside the bile ducts (cholelithiasis).
  • Gallbladder polyp or tumor.

Gallbladder pain can mimic gastritis and peptic ulcer disease.

Symptoms of gallbladder pain:

The summary of characteristics of gallbladder pain is in the below table. Typical gallbladder pain is often due to uncomplicated gallstones. The pain is located in the upper right abdomen. However, many people experience gallbladder pain in the middle of the stomach a few inches above the belly button.

Biliary colic (Uncomplicated gallstone).Description
1. SiteUsually, The right upper quadrant of your abdomen.
2. Spread– The pain may spread to the back of the right shoulder.
– Also, it spreads to the epigastric area (a few inches above the belly button).
3. CharacterConstant builds up then disappears gradually.
4. DurationAt least 30 minutes. It may last up to 6 hours.
5. Relation to Food– Triggered by foods (especially fatty Food and large meals.
– However, it can start spontaneously.
6. NOT related to:Movement, bowel movements, nor the passage of flatus.
7. NauseaOften Present, severe.
8- Commonly associated symptomsVomiting, sweating during the attack.
9. Unusual symptoms.– Heartburn and chest pain.
– Bloating, fullness.
– Early satiety.
– Isolated epigastric pain.
10. Symptoms NOT associated:– Fever.
– Jaundice.
– Prolonged pain for more than 6 hours.
– Extreme tenderness over the gallbladder (Murphy’s sign).
– Vomiting of blood, blackish stool (PUD).

Gallstones may lead to the obstruction of the gallbladder outflow leading to acute cholecystitis (prolonged gallbladder pain and fever).

In addition, gallstones may slip and obstruct the common bile duct leading to jaundice, dark urine, and clay stool.

Learn more about the mimics of gallbladder pain.

5. Pancreatic diseases.

Pancreatitis pain is often located in the upper-middle stomach area (above the belly button). The pancreatic pain is often severe.

The various diseases of the pancreas can lead to such pain. the most common causes are:

  • Acute pancreatitis.
  • Chronic pancreatitis
  • Pancreatic cancer.

Gallstones are among the most common causes of acute pancreatitis (they obstruct the pancreatic duct). Also, alcoholoabuse is among the most common causes of chronic pancreatitis.

Symptoms of pancreatitis:

Acute Pancreatitis:

  • Acute onset, severe, persistent pain in the upper central stomach (a few inches above the belly button). The pain can radiate to the mid-back.
  • Nausea and vomiting are present in about 90% of the causes (reference).
  • The pain radiates to the back (upper mid-back area) in 50% of the cases (reference).
  • Shortness of breath.
  • Fever.

Chronic pancreatitis:

  • Pain above the belly button in the middle of the stomach (less severe than acute pancreatitis pain).
  • The pain often radiates to the back.
  • Recurrent diarrhea, particularly after eating fatty foods. The stool is yellowish or grey, with an oily consistency.
  • Weight loss.
  • Occasional nausea or vomiting.
  • Some patients are asymptomatic.

MORE: Urine Color Changes in Pancreatitis (Acute & Chronic) & Pancreatic Cancer.

6. Others.

The list of the causes below are either:

  • Uncommon or rare.
  • Common but less likely to cause pain above the belly button.

Other causes may include:

  • Irritable bowel syndrome and Inflammatory bowel disease: the two disease affects the colon primarily, the tendency to cause diffuse abdominal pain rather than middle stomach pain above the umbilicus.
  • Food intolerance and allergy: often associated with diarrhea, bloating, and distension.
  • Coronary artery disease: Atypical forms of ischemic heart disease may present with upper-middle stomach pain without chest pain.
  • Cancers: stomach cancer, pancreatic cancer, liver cancer, gastric lymphoma, colorectal cancer, gastrointestinal stromal tumors, and biliary system cancer (cholangiocarcinoma).
  • Liver diseases: hepatitis, liver abscess, liver hemangiomas, liver cirrhosis, and others.
  • Abdominal wall hernia (epigastric hernia): often associated with a swelling in the middle of the stomach above the belly button.
  • Abdominal muscle strain: usually, the pain is associated with movement.

MORE: 7 Causes of Pain 2 Inches Left of the Belly Button.