Sharp Pulling Belly Button Pain: Causes & When to Worry

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The two most common causes of sharp pulling pain in the belly button are umbilical hernia and early appendicitis. Other causes include gastroenteritis, food poisoning, umbilical infections, and others.

Keep reading this article as it will help you to differentiate between the common causes of sharp bulling umbilical pain.

The 3 Commonest Causes of sharp pulling belly button pain

1. Umbilical & paraumbilical hernias (especially if complicated).

An umbilical hernia is a defect in the abdominal wall at the umbilicus or just next to it. It is the second most common type of abdominal wall hernias (reference).

Causes:

An umbilical hernia is often caused by a chronic increase in the pressure inside the abdomen. Common causes include:

  • Pregnancy.
  • Obesity.
  • Ascites (as in patients with liver cirrhosis).

Sometimes (but rarely), these umbilical hernias become complicated (incarceration of a loop of the intestine, infection, or rupture), resulting in sharp pulling pain in the belly button.

Symptoms:

  • Most cases of early umbilical hernia are completely asymptomatic.
  • Pain in the belly button area (often mild but may become sharp and pulling in nature).
  • Flattening of the umbilicus.
  • Swelling in the umbilicus or just above or below it.
  • The swelling may be very small and increases with coughing, lifting heavy objects, or standing.
  • Mild tenderness or pain over the swollen hernia.
  • Symptoms of complications such as severe pulling pain, color changes (redness), or rupture of the swelling.

What to do:

  • Call your doctor if you are not sure about the diagnosis or the presence of complications.
  • Beware red-flag signs such as severe redness or progressive swelling and pain, vomiting, severe abdominal distension, etc.
  • Avoid lifting heavy objectives or vigorous physical activities.

2. Omphalitis (local umbilical inflammation or infection).

Omphalitis is an infection or inflammation of the umbilicus and/or the surrounding tissue. The disease primarily affects neonates. However, it may also occur in adults, especially those who are obese and with inadequate hygiene.

Omphalitis is a type of dermatitis in which the umbilical skin becomes red, painful, and infected.

Symptoms:

  • Redness of the umbilicus and/or surrounding tissues.
  • Severe pain (sharp and pulling) in the umbilicus.
  • The inflammation may extend to the deep tissue (subcutaneous tissues or form an umbilicus abscess.
  • Severe tenderness when the umbilicus is pressed.
  • Also, you may feel tender swelling in the umbilicus.
  • The infection may spread to the blood and cause systemic symptoms such as fever, muscle aches, etc.

Consult your doctor if you have local inflammatory changes in your belly button.

3. Early appendicitis.

The appendix is a small worm-like structure attached to the first part of your colon in the lower right abdomen.

The inflammation of the appendix (due to its obstruction) is one of the commonest intra-abdominal surgical conditions.

Symptoms:

  • Appendicitis pain often starts as a sharp pulling around the umbilicus (belly button).
  • The pain lasts several hours or a day around the umbilicus (belly button).
  • Eventually, the pain often localizes in the lower right abdomen. Also, It becomes extreme to the degree that your movement and breathing are painful.
  • The abdominal pain is often extreme and sharp.
  • The pain is often constant and increases with movement, coughing, or pressing the abdomen.
  • Nausea and anorexia are often present and severe.
  • Bowel habit changes (diarrhea or constipation) are also common.
  • Vomiting may also occur.
  • Fever (in about 40% of the cases of appendicitis.
  • Generalized fatigue and body aches.
  • Sometimes, urinary frequency or urgency occurs with severe inflammation.

4. Acute Gastroenteritis.

Acute gastroenteritis is an infection of your digestive tract. It is one of the most common diseases worldwide.

Acute gastroenteritis typically causes short-term diarrhea, abdominal pain, and maybe vomiting.

Some types of gastroenteritis may start with severe pulling cramps around the belly button area. However, it is not typical for the gastroenteritis pain to be very localized in the belly button area.

Causes:

Gastroenteritis is caused by ingesting an infective organism, though:

  • Eating or drinking contaminated foods or drinks.
  • Close contact with an infected person.
  • Using personal utensils of an infected person.

Common causes include:

  • Viruses such as norovirus, rotavirus, and adenoviruses.
  • Bacteria such as E. Coli, Campylobacter, salmonella, etc.
  • Protozoa such as Giardiasis and amoebiasis.

Symptoms:

  • Sudden onset sharp abdominal cramps (generalized, lower abdominal, or around the belly button area) (reference).
  • Sudden onset watery yellow diarrhea.
  • Nausea.
  • Vomiting.
  • Fever (low grade in viral gastroenteritis, a high grade in bacterial gastroenteritis). However, many causes don’t have a fever at all.
  • Mucus and blood may appear in the stool (especially with amoebiasis and shigella infection).
  • If sharp belly button pain is
  • Other symptoms of gastroenteritis (diarrhea) often follow the onset of sharp belly button pain after a few hours.

Early appendicitis and acute gastroenteritis can be difficult to differentiate as a cause of sharp umbilical pain. The table below illustrates the differences (reference).

 Appendicitis (early stage)Gastroenteritis
1. Abdominal pain LocationAround the umbilicus (bulling pain in the belly button), then shifts to the right.Anywhere, mainly in the lower central abdomen. It can also cause sharp belly button pain.
2. Improvement of pain after defecationNoYes (partial or complete)
3. Nausea onsetAfter the onset of pain.Before the onset of pain
FeverNone or slightNone or slight
Pain on touching the abdomen (tenderness)It may not present around the umbilicus in the early stages.Mild or none.
Vomitingin <50% of cases (children)in >50% of patients (children)
The course of pain-Increases over time-becomes more localized (lower right)starts severe and often decreases over time.
White blood cell countoften > 10000Often < 10000

Less common causes

  • Acute diverticuluits.
  • mesenteric vasculitis.
  • Familial Mediterranean fever.
  • Uterine pain.
  • Psychogenic pain.
  • Severe IBS attacks.
  • Severe ulcerative colitis or chron disease.
  • Acute pancreatitis.
  • Biliary colic.
  • Umbilical trauma.
  • Abdominal muscle strain (lifting a heavy object or vigorous workouts).

When to Worry

you should see a doctor for a sharp pulling belly button pain when there is:

  • Fever.
  • Severe abdominal tenderness (Severe pain when touching or pressing the abdomen).
  • Vomiting.
  • Blood in stool.
  • Localized swelling or redness.
  • Bleeding or discharge from the umbilicus.