“Why does my belly button smell?” – Have you ever asked yourself this question? I`m sure you did, at least once, since you are reading this article!

Belly Button – Anatomy

Belly button, the navel (clinically known as umbilicus), is basically a scar on our abdomen. We generally don’t view it as a scar since we`ve had it for as long as we can remember but it is just that – a scar at the attachment of the umbilical cord.

The navel is so prominent and relatively consistent on the abdomen, it is used to visually separate it into four quadrants: right upper and lower and left upper and lower quadrant. (see abdominal quadrants here)

The Belly Button’s Rain Forrest

To give you a better idea of what goes on in the belly button and why does it sometimes stink, we thought we’d share the results of a research study published on National Geographic Website.

The main goal of the study was to examine the microbial contents of 60 volunteers’ belly buttons. And the results were nothing short of amazing – the scientists discovered a total of 2.368 bacterial species, 1.458 of which may be completely new to science! Meaning an average belly button harbored around 67 species!

Unfortunately the goal of the study was not to answer the question “Why do our belly button smell,” but studies like these help us get a better understanding of ourselves and our bodies.

“Outies” And “Innies” – Anatomy and Smelly Belly Button

Accoring to a certain non-scientific poll, over 90% of all individuals have what is called a innie belly button (a belly button that faces inwards). The rest have an outie.

Now, even though an innie is considered more appealing visually (there are even surgeries designed to transform and outie into an innie), an outward facing belly button is less prone to bacteria growth therefore, less prone to bacteria-induced “foul odor” problem.

We are, of course, not suggesting you should get a surgery if you have and inward facing belly; this is just an anatomical curiosity…

Why Is Your Navel Smelly – Most Common Causes Of A Smelly Belly Button

Navel is generally a place where oil and dirt accumulates, so a “smelly situation” is not as surprising as it may seem at first.

Based on people’s complaints, we can divide this smell into two distinct categories:

1. a strange, undefined smell, harder to pinpoint and
2. a distinct foul smell, resembling poop, cheese or a fish gone bad

Either way, a strange smell (that comes back after you’ve cleaned your navel) is a clear sign that something is wrong and it would be best to get it checked out. Meanwhile, here are some of the most common causes of a smelly belly button:

• Fungal Infection – from what you’ve read so far, you must think that the belly button is the perfect breeding ground for all sorts of infections… Well, you are not that far from the truth actually… The belly button is dark and damp and, as such, suitable for yeast infection growth. Most common symptoms of a belly button yeast infection are:
  • Itching – since the yeast infection will erode healthy skin cells, it may lead to itching. The best way to deal with this itching is to get an anti-itching cream
  • Redness – skin will often become red when irritated but this redness will go away as you start dealing with the infection
  • Discharge and Odor – a thick, white or yellowish discharge is usually a clear sign of a yeast infection, accompanied by a foul odor
• Bacterial infection – belly buttons are prone to bacterial infections, especially when unclean and unwashed. These infections will often lead to a yellowish or even brown discharge, pain and unpleasant smell. A common way to identify a bacterial infection is a fouls smell that keeps coming back even after washing.
• Infected belly button piercing – as surprising as it may seem, the infected navel piercing rate is quite high (in excess of 30%). Common causes are unsterylized piering equipment, touching your piercing with dirty hands and generally poor “piercing” hygiene. You will know your belly button is infected if you notice swelling, redness and tenderness around the piercing. Also, you might notice a rash and a foul-smelling discharge. Since the skin integrity has been broken, these infections can lead to more severe health problems and should be addressed as soon as you spot them.
• Diabetes – Diabetics are prone to infections in general, not only in the navel region. Also, the infections last longer and are more difficult to address and heal. Depending on the severity and duration, these infections may lead to a horrible smelling discharge, resembling fish or cheese gone bad.
• Pregnancy – foul smelling belly button during pregnancy is nothing out of the ordinary and here is why. During pregnancy, obviously, the body goes through a number of changes – physical, psychological and hormonal, and as the hormones start going wild, the metabolism might speed up and result in increased perspiration. This extra sweat will find its way to the belly button and you may notice a certain odor. A quick fix is to clean your belly button twice a day using q-tips with rubbing alcohol.
• UV ligh exposure – it is a well-known fact that UV light damages the skin. The extent of this damage will largely depend on the amount of time you spend exposed to the direct sun light. Overexposure can lead to skin damage which in-turn increases the risk for the development of infections.
• Sebaceous cysts – sebaceous cysts are small, noncancerous bumps under the skin. They are most common on face, neck and on the trunk. These bumps are usually small, reddish with a tiny blackhead opening at the very top of the cyst. Most common way of treatment for these cysts is just to leave them alone. In some rare cases, your doctor will make a small incision and drain them. Even if you do not attempt to drain them, they will sometimes leak with a foul-smelling, thick, yellow pus.
• Urachal abnormalities – Urachus is a remnant of a channel wich connected our bladder and belly button during the first trimester of pregnancy. This channel usually goes away completely around the 12th week of pregnancy. In some rare cases, urachus does not go away and leads to a condition known as patent urachus. Patients with PU are more prone to belly button infections which are accompanied by a strong-smelling discharge.

Why Does My Belly Button Smell After A Tummy Tuck?

It is important to note here that the smell does not appear right after the surgery, patients usually notice it after a few days (even months or years!). When this happens, we usually suspect one of two things:

1. Retained sutures – if you notice a foul smell coming from the navel region few weeks or months following the tummy tuck surgery, chances are there are still some remaining sutures that need to be removed. You should contact your surgeon and sort it out.
2. Navel contraction – sometimes, due to scarring, the navel opening might contract and essentially become too tight so you just skip over it when washing yourself. If this is the case, don’t be afraid to give it a little stretch and allow yourself to access it and give it a thorough, deep cleansing.

Treating Belly Button Smell

Treating is not the same for all patients, it will largely depend on the underlying cause (this is why we always advise seeing a doctor). For example:

• if urachus is the problem, you must undergo a surgery to remove it
• infections are usually treated with topical creams and/or ingestible medication
• diabetes will require lifestyle changes and
• cysts will usually be better off left alone

A Proper Way To Clean Your Belly Button

In addition to pointing to a more serious health condition, a smelly belly button can be plain embarrassing; this is why most people don’t even talk about it and, in some cases, adopt poor hygiene habits.

After reading this article, you won’t be able to make any more excuses ’cause we are going to give you a full navel cleaning routine:

• Preparation – it is always a good idea to gather all the necessities before you begin the cleansing process. Nothing is set in stone here, but you can start with water, baby oil, alcohol, a cotton swab (q-tip) and an astringent
• Dip and clean – dip the cotton swab into your desired cleaning solution and swab your navel. Repeat several times until you get all the dirt out and your navel is nice and clean
• Remove solution – after you remove the dirt, repeat swabbing your belly button with a clean cotton swab until your navel is nice and dry
• Aftercare – after you’ve cleaned your belly button, you should apply a skin care ointment or a cream to nurture and care the skin you’ve just treated!

In medical terminology, itching is generally referred to as pruritus. Pruritus is, therefore, not exclusively tied to itchy ankles, but it may still be used to describe this condition.

Itchy ankles usually point to a certain dermatological problem (skin diseases and conditions) but is can also be a symptom of an internal disorder such as diabetes mellitus, problems with blood vessels and, in the most severe cases, occult carcinoma.

As you can see, there are a lot of potential causes of itchiness around the ankles, and we will go through each and every one of them in the following paragraphs.

What Leads To Itchy Ankles?

Before we dive into the list of causes (that lead to itchy ankles) we cannot control, I would like to first point out a few we are in our control of:

• Inappropriate footwear -often overlooked, this is one of the most common factors which contributes to the development of itchy ankles. As we all know, socks come in direct contact with the skin around our ankles and the material they are made of will play a crucial role here. If you ever wore wool socks you know what we`re talking about. Wooly socks can also irritate your skin even if you are wearing cotton ones underneath, so be careful when choosing your footwear. Also, you should try to avoid socks that are too tight around the ankles (wooly or not), as they can also lead to itching and contact dermatitis.
• Insect bites – the infamous mosquito bites; it seems that nothing else can produce such an intense itching feeling as a mosquito bite on the ankle (wrist can also itch like crazy). Mosquito bites on the ankles are especially common in the evening because most of our body is covered, but our wrists, neck, and ankles are usually vulnerable to attack! Other insects can also cause itching around our feet and ankles such as bed bugs and mites.
• Heat Rash – heat rash is common in athletes, golfers and runners especially. This rash typically occurs in people aged 50 and over, during hot and humid summer months. The main cause of this rash is sweat – what happens is sweat glands become clogged (when wearing tight socks) and the perspiration becomes trapped beneath the surface and irritates blood vessels.
• Bandage – just like the socks, different kinds of band-aids and bandages can irritate the skin, especially if worn over longer periods of time, and cause itching.
• Harsh soaps – most of you are probably not aware of this, but there are very few sweat glands around the ankles; and if you are too harsh with your cleansing routine, or use a harsh soap, you can strip the skin of its essential oils and dry it out, which will result in ankle itching.
• Neurodermatitis – neurodermatitis is a condition that starts with a small patch of itchy skin. As you scratch it, it makes it even itchier and as this cycle repeats, the skin becomes hard and thick. This condition is not life-threatening of contagious and, if you resist the urge to scratch, it can be easily taken care of with over-the-counter creams.

Most Common Causes Of Itchy Ankles

• Poor circulation – poor circulation is commonly present in extremities (arms and legs) and is not a “condition” by itself  but it can lead to other health issues. Among others, it leads to:
• Varicose veins – varicose veins are enlarged veins that are damaged and can’t move blood as efficiently as other, healthy veins. This condition may lead to swelling of your feet and ankles, pain and cramping, discoloration, and itching around the ankles.
• Diabetes – at first glance you would probably not link these two, but itchy skin is usually one of the symptoms of diabetes. High blood sugar levels over a prolonged period of time may result in nerve damage and kidney problems. Unfortunately, people who experience itchy legs, feet and ankles are usually those who had very high blood sugar levels for a longer time period.
• Neuropathy – neuropathy is a disorder where nerves sensory response becomes impaired.
• Asteatotic eczema – asteatotic eczema is characterized by excess water loss from the epidermis (surface layer of the skin). When cells lose water they shrink, lose their elasticity and fissures appear. This condition may lead to itching and inflammation with the risk of an infection. This eczema is common in the elderly population.
• Nummular dermatitis – nummular dermatitis, also called discoid eczema, is a condition where people can observe distinct, coin-shaped sores on the skin around the ankle or elbows. This condition is more common in women.
• Cholinergic urticaria – this is a relatively common immune system disorder characterized by skin`s hypersensitivity to stimuli (heat, emotional stress, or exercise). This condition is relatively easy to diagnose since its most prominent symptom are small hives and patches of red, itchy skin.

Itchy Skin In Pregnancy

It is not uncommon for pregnant women to experience itchy skin, especially in the first trimester. This is the time when skin becomes much more sensitive and even something you would usually disregard (like the quality of your socks) may the be the main culprit behind your itchy legs, feet or ankles.

It wouldn’t hurt, though, to talk to your doctor should you experience itching that seems out of the ordinary in duration or intensity; just to be on the safe side.

Treating Itchy Ankles

Even though itching may seem benign (and it most cases it is), you should generally address it sooner than later. Of course, seeking medical attention is not always necessary, but if your itching is persistent and it just won’t go away, you should get it checked out.

Meanwhile, here are some of the best practices you should follow if you decide to tackle itchy ankles on your own:

1. Stop scratching! I know that this may be easier said than done, but you saw earlier (when we were discussing neurodermatitis), that you can actually do yourself more harm if you scratch that patch of itchy skin consistently.
2. Stopping the itching – one of the most common (and cost-efficient) ways of stopping itching dead in its tracks is using a cold pack. Cold packs will cool down your skin, and should reduce the itching feeling. NOTE: you should apply cold packs up to 20 minutes at a time, no longer. When dealing with insect bites, I also like to use heat. I make sure I set the water temperature to the maximum my skin can take and just let the water run for about 10 minutes. I feel that hot water has a similar effect as itching does, but without the skin damage and irritation.
3. Menthol lotion – applying a moisturizing menthol lotion will have a soothing effect and reduce the intensity of the ankle itching. It will also moisturize (as the name suggests) your skin, prevent it from going dry and cracking. You can use pretty much any lotion you can get your hands on, but if you have sensitive skin make sure you pick one with natural/organic ingredients.
4. Clay – I’ve used clay successfully for battling acne when I was a teen, but clay is also very helpful with itching and skin irritation. When buying, make sure you get untreated clay. Once you apply it, let it dry and rinse off.
5. Aloe vera – aloe vera is pretty much a miracle plant and is used for every skin condition under the sun. All you need to do is break a leaf off the plant, and rub the gooey gel directly onto your skin.
6. Call your dermatologist! This goes without saying really, dermatologist will be able to diagnose your condition and pinpoint the underlying cause of your itching.

I`m not a huge fan of the term “floating rib,” it implies that the rib is just floating around in the abdomen and not doing much. In reality, these set of ribs are heald in place by numerous attachments, even though they are not directly attached to the sternum.

There aren`t a lot of “disorders” commonly affecting these ribs, but there is one which can cause pain in the floating rib area and its called Floating Rib or a Slipped Rib Syndrome. Another common cause of pain in this area is an injury.

What Is A Floating Rib And What Does It Do?

In total, there are 12 pairs of ribs in our rib cage:

1. True Ribs – 1-7 attached to spine and sternum via costal cartilage
2. False Ribs – 8-10 attached to the spine and costal cartilage of the seventh rib (not directly to sternum) and
3. Floating ribs – 11-12 attached to the spine only

Though most people have two pair of floating ribs, some may have only one or as much as three.

The precise function of these ribs is still a sort of a mystery, but the current theory is that they provide a bit of extra protection to the internal organs. As you can see for yourself, this is not the best or the most viable theory, so some speculate that these ribs are remnants of some earlier stage in our evolution.

In any case, their function is not 100% clear but they can cause certain health problems. And we are going to discuss them in the following section.

Floating Rib Syndrome

Though some author`s make the distinction between floating and slipped rib syndrome, they are basically the same. Other common names for it are slipping rib cartilage, nerve nipping, clicking ribs and rib-tip syndrome. This syndrome is less widely known, so identifying it and diagnosing might be a bit tricky.

The best way to diagnose this condition is to do a manual palpation or by hooking the fingers under the ribs and pulling forward. It is also not that uncommon to ask for an X-ray of the affected area to check the correct position of the ribs.

The main characteristic and symptom of floating rib syndrome is, of course, the pain. Patients suffering from it feel the pain at the front of the floating ribs, which intensifies with movement or deep breathing. The pain is usually localized on the left or the right and can vary from a mild ache to sharp, stabbing sensation of pain spreading across the rib cage and abdominal wall.

The most common cause of this syndrome is a traumatic injury. Patients will usually recall some sort of an injury after which they started to experience pain.

Treatment

There is no specially designed treatment for this condition. It is usually enough just to recognize it and administer a proper use of analgesics. Doctor might also instruct the patient to avoid and movement or positions which will intensify the pain.

In more severe cases, (more severe injuries) partial immobilization might be required. And if the rib pops out of its socket and becomes dislocated, physical adjusting and manipulation will help correct its position and return the patient back to normal.

The pain usually lasts for several months before healing completely.

• http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1346531/pdf/canmedaj00268-0035.pdf
• http://www.ncbi.nlm.nih.gov/pmc/articles/PMC536752/pdf/canmedaj00197-0043.pdf
• Image source: wikipedia.org

Where Is Xiphoid Process Located?

As we already said, xiphoideus process is the most inferior (medical term meaning situated below, downward ²) region of the sternum. It is an important anatomical landmark of the thorax which some medical professionals use to properly place their hands for CPR.

Anatomy And Attachments

Despite its size, xiphoid process plays an important role in providing anchor points for large muscle groups, ligaments, and rib cartilage:

• At the top the xiphoid process articulates with the lower end of the sternum body, forming a faucet for the cartilage of the 7^th rib (see the image above)
• Its anterior surface (anterior – medical term meaning in front³ ) supplies attachments to the anterior costoxiphoid ligaments on either side, and a small part of rectus abdominis (a pair of long muscles stretching across the abdomen, “abs”)
• Its posterior surface (posterior – medical term meaning behind⁴ ) supplies attachments to the posterior costoxiphoid ligaments, diaphragm, and Transversus thoracic muscle
• Its lateral surface (lateral – medical term meaning a body part that it further from the center of the body⁵ ) supplies attachments to the aponeuroses of the abdominal muscles (a sheet of tendons that the muscles “use” to attach to each other and to the bones)
• At the bottom, it gives attachment to the linea alba (a fibrous structure that runs down the middle of the abdomen⁶ )

Clinical Significance

Though xiphoid process is quite small and may seem insignificant, it is a vital landmark for:

• CPR – you can use xiphoid process to determine where exactly you should put your hands during cardiopulmonary reanimation
• Distal margin of the heart
• Superior end of the liver
• Central tendon of the diaphragm
• Distal, anterior end of the thorax
• Subcostal angle – angle between the lower borders of the costal (rib) cartilages (you can palpate it yourself)

Causes Of Xiphoid Process Pain

Most common causes of pain in and around the xiphoid process are physical injury, GERD disease, and xiphoid syndrome.

Physical Injury – Swollen, Sore Or Broken Xiphoid Process

Even though the bone is quite small, in case of a fracture it can get detached from the sternum and pushed down towards to the diaphragm and even the heart; for this reason patients with any sort of chest injury (from collision or impact to the thorax) need to be checked out by medical professionals.

• Applying too much pressure – thorax is quite strong, it is designed to protect some of the most important structures and internal organs, but it has its limits. Applying too much pressure can easily cause dislocation or even bone fracture.
• Wrong hand placement – if you place your hands too low on the sternum, you might fracture xiphoid process, even if the pressure is optimal. You need to move your hands towards the center of the sternum, between the nipples.

There was also an interesting case of a 66-year-old man who was presented with an abdominal pain, tenderness and pain in the middle of his chest⁷. The X-ray revealed an abnormal elongation of the xiphoid process. It was later determined that the xiphoid process was broken, pulled down by the abdominal muscles, elongated and later reconnected with the sternum.

The patient then underwent surgery and the process was shortened.

Xiphoidalgia – Xiphoid syndrome – Xiphoid Process Pain When Pressed

Xiphoidynia, also known as the xiphoid syndrome, is a condition where the patient feels pain and tenderness in the lower portion of the sternum. There are some opposing opinions on the frequency of this condition since some researchers think it is rare while others object by saying it is often overlooked.

One of the reason it is commonly overlooked is presence of another, more severe medical condition⁸, such as:

• Heart disease
• Gallbladder disease
• Bone disease

The main characteristics of the xiphoid syndrome are intense, sharp xiphoid process pain when pressed, intensifying pain when bending over or twisting and tenderness to touch. In more severe cases, the pain can radiate to back, neck and shoulders and become so intense patients will feel nauseated⁹.

GERD – Gastroesophageal reflux disease

GERD usually occurs when stomach acid starts flowing back up the food pipe (esophagus) because a band of muscles at the end of the esophagus does not close properly. This irritates the lining of the esophagus and causes GERD¹⁰.

So what does stomach acid have to do with xiphoid process pain? Well, the location plays a vital role here. The esophagus is located behind the windpipe (trachea) which runs just behind the sternum. So the very proximity of these structures is responsible for pain manifestation in this region.

Xiphoid Process Protruding (Sticking Out) After Losing Weight – Tender On Touch

So what is the cause of this protrusion in overweight people? If you read the entire article, you probably noticed the case of a 66-year-old patient with abnormal elongation of the xiphoid process. And, as you could see, it was determined that the Process was broken, pulled down by the abdominal muscles, then elongated and reconnected with the sternum.

A common cause of this fracture is trauma, but it can also be caused by a vigorous physical activity where the rectus abdominis pulls on the xiphoid process and causes fractures and/or dislocation.

A more likely cause of this protrusion, however, is visceral fat (fat found within the body). In obese people, this fat can put additional pressure to the internal organs and the rib cage itself, causing it to expand; and, since xiphoid process is cartilaginous, it can easily get pushed out of its place and stick out. And as the person loses more and more weight, the XP becomes more noticeable.

Most doctors agree that this is not the cause for any concern, on the contrary – its completely normal; but if you experience any sort of pain or tender xiphoid process on touch, you should talk to your GP for just in case.

Xiphoid Process Pain Treatment

Of course, there is no one correct solution for xiphoid process pain. The treatment will largely depend on the cause of the pain and the condition which lead to the pain.

Doctor will usually start by giving the patient some analgesics, to relieve pain. In more severe cases, where the analgesics don’t work, steroid injections might be employed as well.

Applying heat and ice will also help relieve pain and swelling; changes in diet and light exercise will help with GERD and if there is any sort of anatomical abnormality (like in the case of our 66 year old) surgery might be required.

• (1912.) Gray H. Anatomy of the human body
• The Free Medical Dictionary. Retrieved from http://medical-dictionary.thefreedictionary.com/inferior
• Image credits :”Gray116” by User Magnus Manske on en.wikipedia
• The Free Medical Dictionary. Retrieved from http://medical-dictionary.thefreedictionary.com/anterior
• The Free Medical Dictionary. Retrieved from http://medical-dictionary.thefreedictionary.com/posterior
• (August 28. 2013.) Definition of Lateral, Medicine.net. Retrieved from http://www.medicinenet.com/script/main/art.asp?articlekey=6226
• (May 2014.) Linea Alba, Wikipedia. Retrieved from http://en.wikipedia.org/wiki/Linea_alba_%28abdomen%29
• (2011.) Postoperative elongation of the xiphoid process, National Center for Biotechnology Information. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/21697798
• Xiphoid Syndrome Symptoms, Diagnosis, Treatment and Causes, Right Diagnosis. Retrieved from http://www.rightdiagnosis.com/x/xiphoid_syndrome/intro.htm
• (July 2009.) Xiphoid Process, Wikipedia. Retrieved from http://en.wikipedia.org/wiki/Xiphoid_process
• (July 31.2014.) GERD – Definition, Mayo Clinic. Retrieved from http://www.mayoclinic.org/diseases-conditions/gerd/basics/definition/con-20025201