Whether it is a few uncomfortable gurgles as your head hits the pillow or a cramping, stabbing sensation that rips you out of sleep, stomach pain at night can be a real eye-opener. Not only is it uncomfortable while it is occurring, the impact on your sleep can have a negative effect on your overall health. Here’s what causes stomach pain at night — and steps you can take to relieve it.
What Causes Stomach Pain At Night?
It is important to understand a little bit about anatomy when discussing what causes stomach pain at night. The stomach is located in your upper abdomen on the left side of your body. At the top of the stomach there is a valve called the esophageal sphincter. The bottom of the stomach connects to the small intestine. Many people clutch just below their belly button when describing stomach pain, but it generally occurs much higher than that. If you are experiencing pain behind the belly button, it may be associated with another organ system.
However, there are many different issues that can cause stomach pain at night, even if they originate elsewhere.
If you are a human being who eats food and breathes air, chances are good you have experienced gas in your lifetime. It may be the minor effect of the food you eat, but some people experience this kind of stomach upset during periods of stress, too.
Occasional bouts of acid reflux are most often associated with a few eating habits:
- Eating a large meal
- Drinking too much alcohol
- Lying down after eating
Some foods are more likely to cause acid reflux. For example, spicy food that is tomato-based and sugary treats can cause acid reflux.
Chronic acid reflux that occurs more than once a week can lead to bigger health problems like inflammation and scarring of the esophagus, ulcers in the esophagus, and bleeding.
Gastroesophageal reflux disease (GERD) is a digestive order that occurs when stomach acid flows into the esophagus. Although this likely causes pain that resembles heartburn, you may also experience upper stomach pain at night at the top of the stomach opening near the esophageal sphincter.
GERD usually occurs right after eating and in conjunction with certain foods. Other risk factors for GERD are obesity and overeating.
The fact that symptoms of food poisoning often subside within 36 to 48 hours is no consolation when you’re going through it.
Sharp, stabbing pain; nausea; and vomiting are symptoms of this brief but intense condition. You may also experience stomach cramps and an unsteady digestive system for days (and sometimes weeks) after a particularly intense episode.
Irritable bowel syndrome affects each sufferer differently, but one common thread is stomach pain. The cause of this chronic syndrome is not well understood, but it has symptoms that include:
- Stomach cramps and pain
A related condition is Crohn’s disease, a type of inflammatory bowel disease (IBD) that is chronic and can cause stomach and back pain at night.
Stomach, or gastric, ulcers cause burning pain in the stomach area. Pain fluctuates and can be worse when the stomach is both empty and full. Because night is when the stomach is at its emptiest, ulcers can keep you awake.
Common causes of gastric ulcers include:
- Chronic stress
- Excessive use of non-steroidal anti-inflammatory drugs (NSAIDs)
- H. pylori bacteria
Peptic ulcers in the intestines can also cause stomach pain.
Gastritis is the formal name for inflammation and irritation of the stomach walls. If you were to send a camera down and look at your stomach, its walls would actually appear red and swollen.
Gastritis can cause not only pain but also nausea, vomiting, and gas. If left untreated, gastritis can lead to bleeding, ulcers, and even cancer.
For an organ that is not considered essential to life, the gallbladder can certainly cause intense stomach pain. It sits beneath the liver and releases bile that is helpful in digestion. When secretions build up, gallstones ranging in size from a grain of sand to a golf ball can form. If these gallstones get stuck in the duct system, severe and crippling stomach pain can result.
Eating fatty foods increases the likelihood of developing gallstones. Some people do not require treatment. For others, surgery is necessary to remove the gallstones and relieve other symptoms that include:
- Nausea and vomiting
- Light-colored bowel movements
If you experience lower abdominal pain only at night, it’s possible you are having an attack of diverticulitis. Diverticulitis occurs when small pockets in the lower part of the large intestine become home to infection. This infection results in inflammation and pain as well as nausea and vomiting.
Food allergies and stomach pain go hand-in-hand. The body responds to the allergy-causing food with inflammation that can run through the entire digestive tract. In some cases, food allergies can be life-threatening and require immediate medical attention.
In others, stomach pain at night is one of many symptoms that can also include:
- Nausea and vomiting
- Changes in mood
Stomach cancer pain is some of the most intense and difficult cancer pain to treat. The early stages of stomach cancer often have no symptoms. As it progresses, you may have a feeling of fullness and bloating even when you haven’t eaten. You might also experience:
- Nausea and vomiting
- Intense pain
Stomach cancer is very rare. Many of these symptoms are also present in much less serious conditions, but talk to your doctor if you have concerns.
Chronic stomach pain
The most common causes of chronic stomach pain include:
- Gastroesophageal reflux disease
- Irritable bowel syndrome (IBS)
- Spastic colon
- Crohn’s disease
These can be episodic, occurring for a period of time and then going away, or they can be a constant source of pain and suffering.
Rarely, stomach pain can be a symptom of a cardiac event. This is specific to those with myocardial ischemia and is also accompanied by other symptoms such as:
- Pain in the neck and jaw
- Rapid heartbeat
- Shortness of breath
Stomach pain without these other symptoms is likely caused by something other than a cardiac event.
How To Stop Stomach Pain At Night
Identifying the cause of your stomach pain at night is the first step in knowing how to stop it. For many minor conditions, making lifestyle changes can relieve pain entirely, but others require more specialized interventions.
Eat dinner earlier
The early bird special is a good idea when dealing with stomach pain at night. Eating dinner earlier gives your body more time to digest before you lay down for sleep.
Eat smaller meals
If you consume a large dinner and an extra helping of dessert every night, you’re asking a lot of your digestive system.
Instead of eating three large squares a day, try breaking your meals into smaller sizes, with the largest meal around lunchtime and a few healthy snacks sprinkled across the day. This keeps your blood sugar stable and doesn’t overload your digestion. It’s also easier on your system when it is naturally winding down for rest.
Avoid certain foods
Those spicy tacos with extra hot sauce aren’t doing your stomach any favors. Any existing pain or inflammation can be exacerbated by these types of irritating foods. While you don’t necessarily need to swear off spicy foods for good, taking a break can be helpful in easing stomach pain at night. Examine the foods you routinely eat at night to get a better idea of how what you eat is affecting your stomach.
Other foods to take a pause on include:
- High-fat foods
- Foods that produce gas (e.g., broccoli and legumes)
- Citrus fruits and tomatoes (and other high-acid foods)
- Carbonated drinks
If you routinely have a cocktail or glass of wine at dinner, abstaining can help heal stomach pain, too.
Drink more water
Drinking water can help treat a number of conditions that cause stomach pain at night, including heartburn and ulcers, both of which may be caused by excessive stomach acid that can be neutralized by water.
Additionally, water helps replace fluids lost by vomiting or diarrhea, two other symptoms that often accompany conditions that cause stomach pain.
Over-the-counter medications can go a long way to relieve pain and help you get a good night’s sleep. The medication you choose depends on your symptoms, but always check first with your doctor to avoid any complications with other medications you may be taking.
- Gas pain: Choose a medication with simethicone (e.g., Mylanta or Gas-X)
- Heartburn and acid reflux: Antacid and acid reducers (Tums, Pepcid AC and Zantac 75) can help buffer the acid.
- Constipation: Along with drinking plenty of water, add a mild stool softener or a laxative to get your digestive system going.
- Painful cramping and diarrhea: Diarrhea and cramping and be relieved by medications with loperamide (Imodium) or bismuth subsalicylate (Kaopectate or Pepto-Bismol)
- General pain: Aspirin-free medications and acetaminophen are your safest bets, as other NSAIDs and aspirin itself can irritate and worsen stomach pain at night.
For pain that is unrelieved by over-the-counter treatments and other lifestyle changes, prescription medications may help. This might include antibiotics for infections caused by diverticulitis, but it also may include stronger versions of OTC medications for stomach pain such as:
- Proton-pump inhibitors (PPIs)
- H2 receptor antagonists (H2RAs)
Elevating the head at bedtime
If you don’t have at least two hours after your last meal before bedtime, make sure to elevate your head while you sleep. This can be especially helpful for those who suffer from acid reflux and heartburn.
When Should I See A Doctor For Stomach Pain At Night?
When considering visiting your doctor for stomach pain at night, there are a few things to keep in mind.
If you are attending a celebration or special occasion and eat and drink more than you normally do, a brief bout of acute stomach pain and digestive upset is to be expected.
However, if you lay down every night and are unable to sleep because of pain, it’s time to talk to your doctor. They may initially suggest nutritional or lifestyle changes, but it’s important to investigate any pain that occurs regularly.
It can be helpful in the weeks before your appointment to keep track of what you’re eating and when, along with how often you have stomach pain at night and what other symptoms you might be experiencing. This helps your doctor understand potential causes, design diagnostic tests, and make treatment recommendations.
Things To Watch For
If you experience sudden onset of stomach or lower abdominal pain, you may want to consider heading to urgent care for treatment. There are a number of conditions that may not resolve on their own, such as dehydration caused by vomiting and diarrhea due to food poisoning or the rare instance of cardiac event. Stomach and back pain at night can also be a symptom of pancreatitis or pancreatic cancer and should be treated as an urgent medical condition.
Bottom line? If you are hurting and worried, call your doctor.
And if your stomach pain at night is chronic and unrelieved, consider making an appointment with the Phoenix pain management specialists at Arizona Pain. We can help you get a good night’s rest.