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Belly button pain: causes and therapy

Belly button pain: causes and therapy


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Belly button pain is usually understood to mean all those complaints that occur in the area of ​​the belly button, i.e. the rounded recess on the front of the abdomen. There are various causes for this type of abdominal pain, especially in children, for example, they often occur during growth or during psychological stress. In addition to this, a so-called “umbilical hernia” or appendicitis can also be responsible for the symptoms, which can lead to serious complications or secondary diseases. Accordingly, pain on the navel should always be taken seriously and medically clarified in any case.

Definition of navel

The term "belly button" (Latin: "umbilicus") or "umbilicus" for short refers to the rounded depression that is located in the middle on the front of the belly. This occurs in all higher mammals after birth, since the umbilical cord has grown during pregnancy, which connects the embryo or fetus in the womb via the placenta with the mother's bloodstream. This provides the unborn child with nutrients and oxygen via the umbilical cord (Latin "Funiculus umbilicalis"). In addition, metabolic breakdown products (e.g. carbon dioxide) are disposed of via this vascular cord - which becomes about 50 to 60 cm long until birth.

As soon as the blood in the umbilical cord no longer pulsates after birth, the so-called "umbilical cord" or cutting of the umbilical cord takes place, by tying it twice a few centimeters from the abdomen with sterile single clamps. The line is then cut between these two points using scissors or a knife - which is not a problem for the newborn due to the pain-sensitivity of the umbilical cord. The remaining 2 to 3 cm long usually dries out between the fifth and fifteenth day after birth, finally falls off by itself and leaves a small wound - which, however, does not cause any pain due to the lack of nerves. This then usually heals quickly and easily through appropriate navel care until the final navel can finally be recognized.

This can look completely different from person to person depending on the disposition, the nature of the abdominal muscles or the implementation of navel care - whereby a general distinction is made between the frequently occurring inward navel and the convex plate-like outward navel.

Cause: growing pains

Growing pains often occur in children between the ages of three and five years, which occur on the one hand on the legs, but also in the area of ​​the navel. These usually express themselves about abdominal pain, which in some cases can even become colic and lead to the children screaming loudly and continuously, holding their stomach and hardly being able to keep upright or straight from pain. The reason for the discomfort is the growth of the abdomen, on the one hand in length and width, but on the other hand also forwards, which pulls the navel forward and causes painful stretching or straining of the scar cord. Since the navel pulls forward particularly strongly after eating rich foods, it is characteristic of these growth-related complaints that they usually appear about 20 to 30 minutes after eating and are more violent the more the child has eaten. In addition to this, the pain can suddenly improve again when romping, running or jumping, which is due to the fact that the movement of the chyme can distribute itself better, which means that the pain subsides quickly in many cases.

Cause: Functional navel pain

If a child repeatedly experiences severe abdominal pain in the navel area and upper abdominal pain, it can also be a so-called "umbilical colic". This usually occurs in children between the ages of 4 and 12 and affects girls more often than boys. An umbilical colic is characterized by the fact that there are no other symptoms between the flare-ups, but the flare-ups - which often only last for minutes to an hour - can lead to side effects such as paleness of the face, headache or sweating. This form of colic is not based on organic causes, instead it is a so-called "functional" complaint, which mainly occurs in stressful situations (exams, conflicts, unpleasant situations or appointments such as a dentist etc.) or the child is overworked or overwhelmed, for example school requirements. In addition to this, the complaints mentioned can also arise when children experience "positive" stress, be it for example the longed-for birthday or the anticipation of a certain experience. If such symptoms occur again and again, a pediatrician should be consulted as a precaution - as long as an acute relapse does not subside and there is also nausea and vomiting, even immediately. The same applies to pain that first occurred in the umbilical region, but then migrates towards the right lower abdomen - here the child must in any case be taken to a doctor or to a hospital immediately in order to rule out possible appendicitis.

Appendicitis

Abdominal discomfort can also be a first sign of appendicitis (appendicitis). This is a bacterial inflammation of the appendix, a small appendage of the appendix, whereas the appendix itself - despite the name - is not affected. Appendicitis is very common and mostly affects older children and adolescents - infants and older people, however, rarely fall ill. In most cases, the disease begins with pain in the umbilical region, which moves to the right lower abdomen within the next few hours. At this point, the abdominal wall is often so sensitive that pressure on it leads to even greater pain. In addition, fever, loss of appetite, nausea and vomiting, diarrhea, an accelerated pulse and night sweats can occur. The course of appendicitis varies, with a general distinction being made between simple (appendicitis simplex) and destructive appendicitis (appendicitis destructiva). In most cases, the disease takes a positive course and usually heals completely - provided the inflammation is discovered promptly and treated accordingly. However, it becomes problematic if it is already well advanced (gangrene appendicitis), because in an emergency it can cause the appendix to burst or break and the contents of the intestine and bacteria to enter the abdominal cavity (“appendix breakthrough”). If the bacteria spread, the inflammation can spread to the peritoneum (peritonitis) - which can be extremely dangerous and can even be fatal if left untreated. If inflammation of the peritoneum has developed, sufferers usually notice this from suddenly increasing pain, which now affects the entire abdominal cavity, and the muscles tighten and the abdominal wall becomes rock hard.

Appendicitis can have various causes, but the inflammation often arises due to a blockage or narrowing of the exit. In most cases, feces or hard bowel movements are the trigger, but in addition to this, the worm process can also kink and cause secretion and inflammation. The constipation and resulting appendicitis are less often caused by foreign bodies (e.g. cherry, grape or melon seeds), tumors, parasites or worms. In addition, inflammation of the vermiform appendix can also occur in connection with inflammatory bowel diseases such as chromium disease, as well as bacterial infections (e.g. with enterococci or coli bacteria), which attack the appendix and become inflamed.

Umbilical hernia

Even with a so-called "umbilical hernia" (medical: umbilical hernia), navel complaints can occur. However, the term is somewhat misleading here, because it is not an actual "break" of the navel, but an innate or acquired gap in the abdominal wall (hernial portal) through which tissue can bulge outwards from the abdominal cavity (hernial sac ). The hernial sac consists of peritoneum, which is pushed out by the pressure in the abdomen from the so-called “hernial sac contents” (abdominal fat, intestinal parts, etc.). The result is usually the characteristic bulge under the skin near the navel, which can be as small as a cherry, but also as large as a tennis ball.

Often an umbilical hernia occurs immediately after birth because the abdominal wall on the navel is not yet fully developed at this point. As a result of a healing disorder of the umbilical wound or increased pressure in the abdominal cavity (e.g. when screaming or a strong cough), viscera can quickly emerge through the port of fracture on the navel. Accordingly, about every fifth baby is affected, premature babies even more frequently, of whom about 2/3 are born with a birth weight below 1500 g with an umbilical hernia. But even in adulthood, an umbilical hernia can occur, caused by increased loads on the abdominal wall, which lead to such strong pressure in the abdomen that the weak area around the navel has to give way to it. For example, obesity, a family predisposition in the form of weak connective tissue, exercise, frequent lifting of heavy loads, pregnancy or a strong cough are possible.

An umbilical hernia is usually painless in both children and adults and is therefore often not noticed at first. In some cases, however, there is a feeling of pressure or pinching in the fracture area, especially when pressing. Digestion or nausea is also possible, but the most obvious sign in these cases is usually the characteristic “bump” in the area of ​​the navel. If there is still drawing or burning pain and / or a reddish-blue discolouration of the fracture, fever, nausea and vomiting, special caution should be exercised, since this could be a medical emergency that must be treated immediately. Because a painful umbilical hernia indicates a rare fracture (incarceration), in which, due to a sudden increase in abdominal pressure (e.g. when coughing, pressing), intestinal tissue becomes trapped in the fracture portal. As a result, the tissue can no longer be supplied with blood properly and threatens to die - accordingly, a pinched umbilical hernia is a life-threatening emergency and must be operated on immediately.

Belly button pain in pregnancy

Frequently, there is pain around the navel during pregnancy, which in most cases is due to the fact that with increasing size and weight of the child, the abdominal wall is also increasingly stressed. This not only bulges the abdomen, but also the navel. In this context it is often said that the “navel passes”, that is, the navel depression disappears and the navel emerges. This occurs in many pregnant women and is completely harmless in most cases; it only becomes dangerous if a kind of bulge forms in the umbilical area parallel to the bulge - because this indicates an umbilical hernia. Umbilical hernias occur relatively quickly in pregnancy due to the stretching of the abdominal wall and the widening of the abdominal muscles, but are harmless in most cases and have no effect on further pregnancy or childbirth. Usually there is no discomfort from a break - but in addition to the bulge, acute abdominal pain and / or reddish-blue discolouration as well as fever, nausea and vomiting or irregular stool (especially constipation) occur, pregnant women should immediately seek medical treatment. In this case, the intestinal tissue could be pinched in the hernia, which means that the intestinal sections inside the hernial sac can no longer be properly supplied with blood. As a result, there is an increased risk that they will die - which in turn can lead to complications such as sepsis (blood poisoning) or peritonitis.

Therapy options for navel pain

Treatment for growing pains If a child has growing pains in the area of ​​the navel, the most important thing is first of all to take care, because the pain can sometimes become very massive and be accompanied by anxiety and uncertainty. Since the chyme spreads better when moving and the symptoms usually decrease quickly, vulnerable or sensitive children should above all be encouraged to become active after eating, for example by carefully jumping up and down on the bed or running around a bit. In addition to this, a gentle abdominal massage is often helpful: for this, the person massaging should first warm up their hands in warm water. The child now lies relaxed on his back at a pleasantly warm room temperature, then is gently massaged with two to three fingers in a circular motion and clockwise around the navel. The circles are gradually drawn larger until the fingertips reach the ribs and pubis, then the massage process is repeated, starting again with initially small, but then increasing circles around the navel. If no massage oil is at hand, an edible oil (e.g. cold-pressed olive or sunflower oil) can also be used - however, since this is much more fluid, it should only be dosed carefully. The oil should also be warmed up slightly under hot water or in a water bath before use and can also be enriched with a bit of caraway oil from the pharmacy for an even better effect - however, parents should definitely consult a pharmacist regarding dosage and use to let. If the child has additional diarrhea, it should be massaged counterclockwise, in addition, a massage of the lower back can also be very beneficial for the child in the case of navel pain - which is then also carried out with gentle circular movements either clockwise or counterclockwise (in the case of diarrhea) .

Dealing with functional complaints If the complaints can be traced back to umbilical colic, parents should always keep in mind that this has no organic causes, but rather a combination of stress-triggering situations and a predisposition or increased susceptibility to these with complaints to react in the gastrointestinal area. Accordingly, a lot of patience and attention should be given here, and parents should also ensure a calm, stress-free environment and atmosphere. A gentle massage is also suitable for an umbilical colic, in which the stomach is massaged in a circle in a clockwise direction with previously warmed up hands. A hot water bottle or warm, moist stomach wraps are also beneficial. In this case, pain relievers should be avoided, because as these usually only take 20 to 60 minutes to work, a flare is usually already over.

Therapy for appendicitis If the cause of the abdominal discomfort is appendicitis, it is necessary to start treatment as soon as possible to prevent complications such as a breakthrough of the appendix. Accordingly, patients with suspected appendicitis usually always stay in the hospital for observation, where they can not eat until the diagnosis is finalized, so as not to take any health risks in the event of a necessary operation under general anesthesia. If the diagnosis is clear, the inflamed worm process is usually surgically removed (appendectomy), whereby minimally invasive surgical methods (laparoscopy) are increasingly being used here instead of the classic "open" operation with an abdominal incision (laparotomy). After the procedure, the patient can usually be discharged home after about four days - even if the stitches have not yet been removed, because this can also be done on an outpatient basis without any problems. Afterwards, however, care should be taken to rest and take care, since walking is usually associated with pain in the first time after the operation, and this usually has to be slowly "learned" again.

Treatment for umbilical hernia If a child is suspected of having an umbilical hernia, parents should immediately consult a pediatrician to have the symptoms clearly clarified and, if necessary, to advise on the next treatment steps. In most cases, however, an umbilical hernia is harmless and regresses through the strengthening of the abdominal muscles in the first two years of life, so that no special therapy is necessary. Accordingly, parents should never try to have the umbilical hernia broken by an umbilical patch or the like. to push back, because these measures can possibly even further damage the child, for example by allergic reactions or inflammation or the intestine being pinched by a too loose plaster when healing. Instead, a "normal" break should only be checked regularly. The situation is different, however, if the umbilical hernia is still more than 1 cm wide after the second birthday or if it increases continuously or if the hernia is trapped - it may then be necessary to have the hernia closed under general anesthesia in a small operation. However, umbilical hernias rarely need to be operated on because of the very high rate of regression in the first years of life.

However, since an umbilical hernia cannot heal on its own in adults, it is usually operated on to alleviate any symptoms and to minimize the risk of life-threatening trapping. If the umbilical hernia is already jammed, it is a medical emergency that must be operated on immediately to prevent intestinal tissue from dying off. The course of the operation depends on the size of the umbilical hernia: if the tear is smaller than about 2 cm, the abdominal wall is then sewn directly after the hernial sac has been moved back into the abdominal cavity; in the case of larger tears, however, this is additionally reinforced with a plastic net to prevent this Reduce risk of further breaks. Most of the interventions take place under general anesthesia, but in the case of smaller fractures, local anesthesia is sometimes sufficient. In some cases, it is even possible to operate on an outpatient basis so that the patient can leave the hospital on the same day.

Naturopathy for pain on the navel

If more serious reasons (pinching, advanced appendicitis, etc.) for the pain in the region of the navel can be medically ruled out, various treatment methods from the field of naturopathy and home remedies for abdominal pain are also available as an alternative. While nausea and diarrhea indicate a gastrointestinal infection, stomach pain or stomach cramps, for example, are often a sign of stress and grief - which is why it is always worth using natural remedies here instead of using painkillers straight away. However, it is important to always consult a doctor if you experience a fever, increased heart rate or persistent nausea, since navel pain is often an irritation of the appendix.

In general, flaxseed wraps have a calming and soothing effect on navel pain or abdominal cramps. For this, a cup of flaxseed is placed in a pot, filled with water until it is covered and boiled. The finished, warm porridge is now distributed in the middle of a kitchen towel the size of your palm. Then the edges of the cloth are folded over and the package is placed on the painful area for two to three hours - until the mass has cooled.

In addition to this, there are various medicinal herbs for navel complaints: chamomile, which has a relaxing and calming effect and can be used both as a tea or a tincture, has proven its worth here. In addition to their own, caraway, fennel, coriander, apple mint or ginger (pure or as a tea) are also very good. Warmth is also a popular means of counteracting painful cramps in the stomach or stomach. Either the tried-and-tested hot water bottle can be used here, but cherry stone or grain cushions have also often proven their worth, especially with children, since there is no risk that the little patients injure themselves in the hot water.

Children, in particular, often find massage to be very beneficial in the case of pain on the navel, because this not only “works” on the painful areas, it also often creates a positive psychological effect through the proximity and touch of the familiar person. Here, for example, it is advisable to massage a little warmed fennel or chamomile oil into the stomach in a clockwise direction with hands previously warmed up, the circles gradually being drawn around the navel.

In order to counteract psychosomatic navel discomfort caused by stress, grief or worries, care should also be taken to find one's “own center” (again) and to develop suitable strategies accordingly in order to cope with the requirements in the professional and private sphere. There are various exercises and procedures for reducing stress such as yoga, autogenic training or meditation. Psychotherapeutic treatment can also be a useful way to identify the causes of the pain or to deal with deeper conflicts or fears. (No)

Author and source information

This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.

Dipl. Social Science Nina Reese

Swell:

  • Jürgen Stein, Till Wehrmann: Functional diagnostics in gastroenterology, Springer Verlag, 2nd edition 2006
  • Parswa Ansari: Appendicitis, MSD Manual, (accessed 03.10.2019), MSD
  • Michael Braun: Acute Appendicitis: Modern Diagnostics and Therapy, Hessisches Ärzteblatt 1/2016, pp. 17-21, (accessed 03.10.2019), LAEKH
  • Volker Schumpelick: Operation Atlas Surgery, Thieme Verlag, 2nd edition, 2006
  • Frank H. Netter: Netters Internal Medicine, Thieme Verlag, 2nd edition, 2013
  • Parswa Ansari: Abdominal wall hernias, MSD Manual, (accessed 03.10.2019), MSD


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