Nighttime abdominal pain, sometimes called stomach pain, is a common problem and can occur for various reasons. Often, it is due to digestive issues, but sometimes there is a more severe underlying issue.
Here, learn about some common causes of nighttime abdominal pain and how to manage or treat it.
Digestive problems are considered the most common cause of abdominal pain at night.
Eating close to bedtime means digestion is more likely to occur while lying down, making it easier for stomach acid to travel back up the digestive tract.
Lying down can also increase pressure on some muscular, joint, or bone injuries, making pain and discomfort more intense.
Here are some common causes of nighttime abdominal pain:
Gas usually enters the body when people swallow gas, for example, when smoking, chewing gum, eating quickly, or consuming fizzy drinks. Certain bacteria in the gut also produce gas when they break down carbohydrates. Sometimes, it results from a medical condition, such as IBD or food sensitivity.
Various factors may increase the risk of acid reflux, such as:
- high alcohol consumption
- overeating, especially close to bedtime
- lying down too soon after eating
- being overweight
- high-fat, spicy, and fried foods, along with chocolate and coffee
Gastroesophageal reflux disease
Gastritis is when the stomach walls become irritated and inflamed. This can lead to a sense of pain or burning, as well as nausea, vomiting, and gas. Untreated cases can lead to ulcers, bleeding, and cancer.
Stomach and intestinal, or peptic, ulcers
Stomach ulcers and intestinal ulcers
- H. pylori bacteria
- overuse or prolonged use of nonsteroidal anti-inflammatory drugs (NSAIDs)
- tumors, in rare cases
Fatty or rich meals can worsen gallstone symptoms since bile helps the body digest fat.
Some individuals with gallstones have no symptoms and do not need medical help. People with recurring gallbladder pain or inflammation may need surgery to remove the gallbladder.
As well as pain, gallstones can also cause the following complications:
- nausea or vomiting
- yellowing of the skin and eyes
- unexplained exhaustion
- light-colored stool
Irritable bowel syndrome
Some people with irritable bowel syndrome (IBS) experience nighttime abdominal pain.
Around 5–10% of people have IBS, and most are under 50.
An allergy to gluten, a protein in wheat, barley, rye, and spelt, causes inflammation of the small intestine, often with cramping and abdominal pain. Genetic factors probably underlie the allergy.
Without diagnosis or treatment, complications can arise. They include dental problems, delayed puberty, mood changes, and reduced growth due to vitamin and mineral deficiencies.
Experts do not know why it develops, but it may be due to an autoimmune reaction or genetic factors. Smoking may also increase the risk.
Symptoms range from mild to severe and may affect the back and legs. There may also be nausea, vomiting, headaches, and other symptoms.
With endometriosis, tissue similar to endometrial tissue grows outside the uterus. This can cause severe or persistent pain, bleeding and spotting, and digestive problems. It can make it harder to become pregnant.
Endometriosis may affect
Individuals with a food intolerance have a sensitivity to certain foods and cannot properly digest or process them. They may experience pain, bloating, diarrhea, and gas. Symptoms usually start soon after eating the food but may appear up to 48 hours later.
Lactose intolerance is a common food intolerance that causes severe abdominal cramping and pain.
Constipation makes it difficult to pass stool. As a result, waste products build up in the colon, leading to distention, pain, and pressure throughout the abdomen. Stools will be hard, dry, and difficult to pass.
Often, nighttime abdominal pain is not a reason for immediate concern. Severe or persistent symptoms, however, need medical attention.
People also should seek medical advice if they have additional symptoms, such as:
- severe or ongoing pain that does not lessen with over-the-counter medications
- difficulty breathing
- unexplained weight loss
- abdominal swelling or inflammation
- abdomen that is painful to touch
- yellowing of the skin and eyes
- ongoing nausea or vomiting, especially if vomiting blood
- blood in the stool
- pain that occurs during pregnancy
- joint and muscle aches
Sometimes, sudden severe pain can indicate a more serious condition, such as appendicitis. Appendicitis can cause pain that begins around the belly button and travels downward into the lower right side. It then usually worsens with the slightest activity or movement.
Other conditions that involve severe abdominal pain and need medical attention include:
- Kidney stones. Sharp, stabbing pain that begins in the mid back and spreads to the abdomen can indicate kidney stones. There is often blood in the urine.
- Food poisoning. Food poisoning can cause intense and sudden vomiting, nausea, diarrhea, and fever or chills. A person should see a doctor if they have a high fever, vomiting or diarrhea that is severe or contains blood, dehydration, or diarrhea lasting longer than
- Cardiac events or conditions. A person should seek urgent medical help if abdominal pain occurs with changes in heart rate, sweating, nausea, vomiting, difficulty breathing, tingling in the arms or chest, or pain in the jaw and neck. It may be a sign of a heart attack.
- Hiatal hernia. Occurs when a part of the stomach passes into the chest cavity. Lying flat can increase reflux symptoms that commonly occur with a hiatal hernia.
- Cancer. Stomach cancer and other cancers in the abdominal area can cause various abdominal or digestive symptoms that may be severe, persistent, or both.
In the case of any of these conditions, medical evaluation is important to receive a proper diagnosis and treatment.
The table shows some treatments and home remedies for conditions that cause abdominal pain at night.
|Condition||Treatment options||Home remedies|
|gas||medications to reduce gas or address an underlying health condition||avoiding swallowing air, for example, by eating slowly; eating smaller meals more often; avoiding foods that cause gas|
|GERD, acid reflux, indigestion, heartburn||H2 blockers, proton pump inhibitors (PPIs), surgery, endoscopy|
|stomach and intestinal ulcers||PPIs; antibiotics to treat H. pylori|
|gallstones||surgery to remove the gallbladder|
|IBS||eating more fiber, avoiding gluten, following a low FODMAP diet, exercising, managing stress, getting enough sleep|
|celiac disease||avoiding all products containing gluten|
|Crohn’s disease||medication ||avoiding fizzy drinks and high fiber foods, staying hydrated, eating small meals more often|
|menstrual cramps||NSAIDs for pain relief, birth control pills|
|endometriosis||NSAIDs for pain relief; hormonal treatments; surgery||herbal teas (such as licorice or cinnamon) and supplements |
|food intolerance||avoid products containing the substance, such as lactose||checking labels to avoid foods containing the substance; using alternatives, such as oat milk for people with a lactose intolerance|
|constipation||laxatives or stool softeners; changing existing medications; surgery, in some cases||dietary fiber, water, and exercise |
Tips for preventing and managing nighttime abdominal pain will depend on the cause.
- avoiding eating close to bedtime
- raising the head of the bed while sleeping
- avoiding rich or fatty foods, coffee, or chocolate at night
- avoiding or limiting alcohol consumption
- avoiding overeating
- using over-the-counter medications
- asking a doctor about symptoms that could indicate an underlying condition
Here are some answers to questions people often ask about abdominal pain at night.
What causes abdominal pain at night?
Pain that is worse at night is often due to digestive issues, such as gas. Sometimes, however, there may be a more severe underlying cause, such as IBS or IBD.
What can I do about abdominal pain at night?
The first step is to try eating smaller meals and avoiding eating close to bedtime. If dietary changes do not help or symptoms are severe or persistent, a person should seek medical advice.
There are many possible causes of abdominal pain at night, ranging from gas from eating too fast to more serious conditions that may need surgery.
Tips that may help include eating smaller meals more often, avoiding eating too near bedtime, and eating more slowly.
Anyone with concerns about symptoms should seek medical advice. A doctor may recommend lifestyle changes or do tests to identify an underlying cause.