Stomach Pain at Night (Digestive Nighttime Pain) Adults, Children

Stomach pain is a common term to describe upper abdominal pain, particularly pain or discomfort on the left side and center (epigastrium). The abdominal cavity contains many structures and organs, most of which are part of the digestive tract. It is lies next to the thoracic cavity which houses the heart and great blood vessels as well as the lungs and terminal airways. The abdominal cavity and thoracic cavity are separated by the muscular diaphragm.

Stomach pain may be associated with any of the structures contained within these two cavities and needs to be carefully assessed in conjunction with other symptoms to reach a possible diagnosis. This is further evaluated with diagnostic investigations. On its own stomach pain is not an extremely accurate indicator of a specific pathology. It is largely non-specific and a common occurrence without any clear cause. Stomach pain may come and go sometimes with no correlation to specific events and therefore concurrent symptoms need to be identified as far as possible.

Meaning of Stomach Pain at Night

Stomach pain at night is a symptom that may be specific for certain diseases but typically other clinical features will be evident. It can also be due to a host of causes that causes pain irrespective of the time of day. The first consideration when evaluating stomach pain at night is whether a meal was consumed recently (stomach pain after eating). This may be a more likely aggravating factor of a condition that presents with stomach pain rather than just the time of day.

Another common association with stomach pain that is more common at night is lying down, whether on the back (supine) or face down (prone). These changes from the upright position may also be a more likely factor for eliciting or aggravating pain associated with certain postures rather than time periods. However, the body’s natural 24-hour cycle (Circadian rhythm) also causes certain organs to become more or less active at certain times at the day and night. It is during these physiological changes in activity that pain may become apparent in a diseased organ.

Is it Stomach Pain?

Position of the Stomach

It is difficult to correlate upper abdominal pain specifically with pain emanating from the stomach. Although the terms stomach and abdomen are commonly used interchangeably, it is essential to differentiate between pain in the anatomical region of the stomach and upper abdominal pain in general. The upper abdomen includes the right upper quadrant (RUQ) and left upper quadrant (LUQ). More specifically this includes the right hypochondrium (RH), epigastrium (E), left hypochondrium (LH) and superior (upper) parts of the right lateral (RL), umbilical (U) and left lateral quadrants as indicated in the picture below.

The anatomical location of the stomach as illustrated above indicates that it is largely or partially in at least four of these quadrants (E, LH, U and LL). While pain associated with the stomach would be more prominent in these quadrants, it is important to remember that the pain may radiate to surrounding areas and even refer to sites away from the stomach.

Pain that is associated with eating or drinking is a more conclusive indication of pathology within the stomach or other parts of the digestive tract rather than just the anatomical location. The position of a person – upright, supine or prone – may also alter the location of the stomach to some degree as well as distension of the stomach after eating particularly large meals.

Causes of Stomach Pain at Night

Symptoms of Painful Stomach Disorders

The main consideration when evaluating stomach pain is to ensure that it is not cardiac pain that is radiating to the epigastrium. This is common with a host of cardiovascular pathology, particularly ischemic cardiac pain. Severe pain that tends to radiate up to the neck, arm (generally left) and upper abdomen, breathlessness, unexplained sweating, paleness or bluish discoloration of the skin, and dizziness should all be considered as a a presentation of cardiovascular condition. It is a medical emergency that needs urgent care.

However, many gastrointestinal causes may elicit pain that closely resembles cardiac pain although the other concomitant symptoms are not present. Acid reflux is one of the more common of these causes. It can be confusing for the average person to differentiate between cardiac and esophageal pain, although any pain that is relieved by antacids is less likely to be cardiac. Nevertheless medical attention should be sought whenever in doubt. Read more on cardiac vs non-cardiac pain.

Conditions associated with gastric acid are more likely to be aggravated at night due to increased acid secretion and possible retrograde flow if the lower esophageal sphincter is compromised. The more common causes of pain that tends to worsen or start at night includes :

  • Gastritis. Inflammation of the stomach wall that is more commonly caused by H.pylori infection or NSAIDs. It typically presents with a gnawing and nagging pain that may be worse after eating and at night during sleep. Nausea, vomiting, indigestion and belching are other symptoms that may be noted.
  • Peptic ulcers. Open sores in the stomach and/or duodenum (first part of the small intestine). Pain is generally more severe than gastritis and may be eased to some extent with eating (stomach ulcers) or worsened a short while after eating (duodenal ulcers). Other symptoms like nausea, indigestion, vomiting and belching are common.
  • Acid reflux. Backward flow of the stomach contents into the esophagus that typically causes heartburn (burning chest pain). Acute acid reflux is more frequently associated with excessive alcohol consumption, overeating, exercising or lying flat after meals. In chronic reflux (GERD ~ gastroesophageal reflux disease), the backward flow of gastric acid into the esophagus may occur independent of meals. Since the lower esophageal sphincter is compromised in GERD, lying flat will allow even minute amounts of acid to flow into the esophagus and elicit pain. Other symptoms may include nausea, vomiting or regurgitation, morning sore throat, belching, and sensation of pressure in the chest (bloating).
  • Gallstones. Gallstone pain tends to occur in attacks when the stones lodge in the bile duct. It is more likely to occur after a fatty meal and also at night. The pain is typically excruciating, more towards the right upper abdomen and extending to the shoulder. Nausea, vomiting, fever, jaundice and pale stools are other features that may be present to varying degrees.
  • Pancreatitis. Acute inflammation of the pancreas (acute pancreatitis) is usually of sudden onset with intense pain, nausea, vomiting and fever. The pain tends to radiate to the back and is moderately relieved from bending over or lying in the fetal position. Acute pancreatitis is more frequently seen in association with overindulgence in alcohol and repeated attacks are common in alcoholics.

Conditions that are more common in the lower gastrointestinal tract may extend upwards into the proximal parts of the small intestine and stomach. However, the location of the colon, the transverse colon in particular, may present as upper abdominal pain.

  • Inflammatory bowel disease. Chronic inflammation of the bowels characterized by two major conditions – Crohn’s disease and ulcerative colitis. Abdominal pain is more common with Crohn’s disease which also presents with watery, large-volume diarrhea and weight loss. Pain is prominent in acute episodes of both Crohn’s disease and ulcerative colitis and is usually worse with eating or defecation in Crohn’s disease but temporarily relieved with defecation (bloody, mucus diarrhea) in ulcerative colitis.
  • Irritable bowel syndrome. Despite the name, irritable bowel syndrome (IBS) tends to cause many symptoms in the upper gastrointestinal tract. This may include excessive belching, abdominal distension and bloating, apart from the change in bowel habit and intestinal cramping when present. Generally the symptoms of IBS ease at night during sleep and are worse in the day but symptoms may exacerbate at night,particularly when associated with the intake of trigger foods and drinks, cigarette smoking or stress.

Nighttime Stomach Pain in Children

Many of the causes listed above affects both children and adults. Although gastritis, ulcers and acid reflux was traditionally considered to be disorders affecting adults primarily, it is now known that children may be equally afflicted. However children present slightly differently and may not report symptoms as accurately as adults.Pain will lead to irritability, night time awakening and children often complain of the need to defecate as they misunderstand the nature of the pain. Vomiting is a common feature associated with pain and fever indicates an infectious cause.

Two conditions in children that are better understood in recent years are cyclic vomiting syndrome and abdominal migraines. These terms are often used interchangeably since vomiting is prominent in abdominal migraines and abdominal pain is prominent in cyclic vomiting syndrome. The dominant symptom determines which label will be used. Cyclic vomiting syndrome is recurrent episodes of vomiting. Abdominal migraines is recurrent episodes of abdominal pain for no known cause and more often seen in children with a family history of migraines (head). Both conditions tend to worsen at night.

Parents are sometimes quick to label stomach pains as a means of seeking attention, avoiding undesirable tasks or playing ‘sick’ from school. Indeed where adults manifest with headaches, children tend to complain of stomach pains. However other symptoms should be noted and the reports taken seriously if there are any other severe symptoms or the child is becoming pale, listless or displaying uncharacteristic behavior.

Please note that any information or feedback on this website is not intended to replace a consultation with a health care professional and will not constitute a medical diagnosis. By using this website and the comment service you agree to abide by the comment terms and conditions as outlined on this page

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  • Elaine Prince

    Hi I have abdo pain that wakes me at night that is getting worse. I go to sleep on my side but if I go in my back I cant turn over. I then need to pull my self up with head board. Turning back into recovery position relieves the pain. I saw my Gp with this which started 5 month ago. Had ultrasound- nothing significant, hip scan- nothing significant. I got referrerd to muscular skeletal dept who did MRI- result I have a bulging disc which he says is causing no pressure on my nerves. He suggests I go back to Gp. Im worried its gone on so long. Trying to get appointment with GP is like getting through the maffia on front desk. My friends say turn up at A&E but im reluctant to do this despite being in so much pain at night time. im exhausted as Im not getting sleep and i hold down a full time job. Any suggestions ??

  • Hi Elaine. The fact that the GP and specialist have not found anything at this point does not mean that the problem is minor. It may not seem like the A&E is necessary but if you’re in such severe pain then it may be a consideration at this point. Ideally you should consult with an orthopedic specialist for further investigations because it does seem to be musculoskeletal. However there is no way we can say for sure through an online platform. If you have been using a national health system in your country it may be advisable at this point to consider seeing a private specialist.

  • andrea summerville

    Hi, my dad has severe stomach pain at night the come and go, more come than going. He has been to several doctors both in state and out of state, he’s was given so many different medication that relates to Acid Re flux, Chronic Irritable Bowel Syndrome (IBS), Gastro…you name it!!! he has changed his diet to nearly nothing, eliminated beverages to just water and yet the problem continues. Cat scan, MRI every test you can think of was taken and yet nothing was found, yet he suffers. He is 76 yrs old. I don’t want to hear one day want some doctor to tell us/his children that he has a condition that went untreated and now it is too late. any suggestions?

  • melinda

    I have been awakened with stomach pain vomiting diarrhea mainly at night/morning (1-3a.m) I am taking omeprazole 40mg daily for acid reflux. My question/concern is this happens once or twice a month since November 2014. I have heart burn stomach and chest pain acid taste in my mouth I’m dizzy my lower back hurts. What can I do?

  • Nate

    I’m 16 and in the middle of the night, my left side just started hurting and don’t know why? Hurts to turn over and to breath to a certain amount. Help?

  • Hi Andrea. Without knowing the exact diagnosis it is difficult to respond with any degree of certainty. His age is of course a major complicating factor as well as the ability to recover from chronic conditions at his age is usually significantly lower than a younger adult. Hopefully he has had a complete upper GI endoscopy and possibly a biopsy of any lesions that was done by a gastroenterologist. If you are consulting with a specialist gastroenterologist and gone through the battery of tests recommended then it is difficult to do much more. It is possible that someday the condition will be diagnosed once it is too late to treat effectively. That cannot be prevented even by the most skilled practitioner. Hopefully that is not the case here and a definitive diagnosis is made soon. Beyond that it is difficult to comment any further.

  • Hi Melinda. The cause has to first be diagnosed or it is difficult to say what you should do or how serious it is. There is a different between the regurgitation seen with severe reflux and vomiting. The 1-3am period is when your stomach acid secretion increases due to the natural ‘clock’ known as the circadian rhythm. Acid suppressing drugs like omeprazole should help but will not necessarily stop the condition altogether. It would be advisable that you consult with a gastroenterologist and undergo further tests to verify whether it is just severe reflux or whether it is some other underlying condition.

  • Amy

    Hello, last September I started having upper abdominal pain at night. Some nights I have pain and some nights I don’t. When It happens, it’s always between 3-5 am. The pain lasts a few hours and stops almost as suddenly as it starts. When the pain first started I had two trips to the er due to severe pain and vomiting. The second time they did a ct scan and discovered a large mass in my right adrenal gland. It was 12cm. I was treated with protonix for my stomach for 5 days in the hospital while they determined what to do about my adrenal mass. I had one doctor who was convicted my pain was from the adrenal mass pushing on other organs in my body. They continued to give me protonix but after the mass was removed they stopped. I have not had pain in my stomach since October but in the last week it has started again. It doesn’t seem to matter what I eat, if it happens, it happens and if it doesn’t then I’m lucky and get to sleep all night. I am currently taking prescription acid reducer but I’m not sure if it’s really working. I haven’t had any upper GI testing at all.

  • Joanne Bam Bam Allen

    Hi My son is having really bad stomach pain only at night. He gets the pain every night and I’m not sure what to do. He walks the floors for hours before he can settle. He is having ibrofren and paracetamol every night for the past 6month. My worry is he is 4 yrs in complete remission from leukaemia he is not back at the hospital till September. And it’s a struggle to get him to my own gp has he has fear of hospitals and doctors. He is age 13 any advice pls

  • HI Amy. This sounds a lot like gastritis or esophagitis. The medication that you were previously prescribed reduces stomach acid production. Typically stomach acid production increases around the early hours of the morning that you mention. It can then worsen gastritis pain or stomach ulcers if present. Further testing like an upper GI endoscopy may be needed. It may be advisable to see a gastroenterologist at this point.

  • Danielle

    I’ve been suffering with abdominal pain at night for about 3 months, it’s in my upper abdomen and gradually gets worse as the day goes on. I take ibopufren every day to help me sleep. It happens so often, it doesn’t seem to matter what I eat..its always the same. If I’m not in pain , I feel nauseous, if I don’t feel nauseous I have back pain..I also have aching legs like when you’re on your period . I’ve had PID before so I’m wondering if it’s that again!? I’m going to see my go this week but was hoping someone could help here too..TIA! x

  • Uri

    I’ve been suffering from stomach pain while lying down for the past 3 years. One day it just hit me and ever since whenever I lay down I get stomach pain and cramps that gets worse the more I lay down. And it doesn’t go away right away when I get up, only after a few hours when I go to the toilet. Doesn’t matter if I sleep or not during that time. And it completely messed up my sleep.

    I’ve been through all the tests, does anyone have any idea? Seems like nothing makes this better, only worse. If I eat spicy food, or drink alcohol, but I’m not sure it’s related.

  • Nelson

    I have stomach pain now for 3 months. Always at night while I sleep, sometimes i get some night sweats. I feel better in morning after bathroom. It has been scaring me. I do have hep c in which I’m going to receive treatment with in the month because doc says it has been active. Would stomach cramping feeling like pain be from that? The pain is mostly in the lower middle, but my liver is located upper left where thought the pain would be if it was hep c related.

  • Hi Nelson. It could very well be related to the hepatitis that you currently have. However, it could also be another condition entirely. In fact your night sweat and abdominal pain may not even be related. There are so many possibilities when it comes to symptoms like abdominal pain and it is therefore important that you have this checked up. You may need to undergo further investigations beyond what you have had thus far for the hepatitis and only then may the underlying cause be identified. Conditions like gastritis for example do worsen at night as the stomach acid increases in the early morning hours. However, this pain as well would be more likely to be felt in the upper left side of the abdomen. Your doctor will advise you accordingly.

  • Hi Uri. As you can see from the post above there are a host of possible conditions that could cause some of these symptoms. Certain conditions like a hiatal hernia or even acid reflux can worsen when lying down whether you sleep or not. However, this should have been detected since you say that you have been through all the tests. An upper GI endoscopy, barium swallow, colonscopy and so on would have found some abnormality present related to the more common condition. Hopefully you have been seeing a gastroenterologist at this point and it may be worthwhile getting a second opinion from another gastroenterologist. Of course it is possible that this is not related to the digestive system and your doctor may then refer you to another specialist. Look at getting a second opinion since nothing was detected with all the prior tests.

  • Tracy

    My 5 year old daughter has stomach pains every night for the last few weeks is not eating as well as she used to? previously had threadworm a few weeks ago but it was treated any ideas?

  • Acquiline

    Hi i have stomach pain only in the night for almost 6days now. It pains me like someone who needs to go to the toilet but if i go nothing comes out. During the day i only feel the pain here and there but not as severe as in the night. What could this be?

  • Jill

    Hi, I have been having pain in my lower stomach mainly on the right every night for about 3-4 weeks, this has been happening on and off for about 2 years. It occurs anytime between 1-4am and last a few hours, I get up and pass a bowel movement slight relief but when I lay down again the pain starts. I take a couple of pain killers and wait for it to pass. Have had a colonoscopy which was clear, I get no pain at all during the day. GP says a form of its but cannot find a trigger point and surly would happen during the day as well, any comments/thought would be appreciated

  • Mike

    Morning , so for the last 5-6 nights after about 3-4 hours of sleeping I have a dull pain under my ribs that i feel through from front to back its not a shooting pain but more of a cramping sensation – not cramping like a runners stitch but more of a general dull contraction cramping – during the day no issues this only occurs at night – thanks for any help

  • Hi Jill. The very specific time when this occurs is a bit confusing. With conditions of the stomach (you refer to the lower abdomen) there can be an aggravation around the time you describes as gastric acid secretion increases around this time. Therefore conditions like gastritis and acid reflux worsens at this time but it would not explain the lower gastrointestinal condition that you are experiencing. It would be advisable to consult with a gastroenterologist for further clarification.

  • derika douthit

    I’ve had the same thing i have a condition where my pain is 20x worse then the average person but I just started experiencing the same thing you are talking about it only comes at night and nothing helps but I also have the worst smelling and tasteing burps also known as diarea burps and everyone asks if I had farted and it’s so imbaressing to tell them the truth that it came from my mout

  • kaustubhan srivathsan

    someone I know, is getting left side stomach pain only at night, (not during the day), and occurs around 2:00am in the early mornings precisely almost every day . He is having dinner around 7:00pm. Is it purely acidity? Would having some water and milk help?

  • Flyercrazy

    I have a similar pain, when I lie down to sleep I will wake up hours later with a dull pain below my belly button, very uncomfortable and painful. This has been going on for year with me so I tired sleeping on a nice soft chair I could tilt back with my feet up so I was not in a complete prone position which cured my problem. I have been sleeping this way for the past 7 or so years with absolutely no stomach pain. Last night I tired to sleep like a normal person thinking after all this time maybe things would return to normal, wrong, same pain.
    I have no idea what it is, I suppose it is time for another colonoscopy, I have diverticulosis which is the result of diverticulitis, but it is not an issue but may be causing the night time pain. I will try to find out. IN the mean time try sleeping in a chair as I have if you can no longer continue with the pain, which is why I made the change.
    Best of luck to you

  • Nick

    The past 2 weeks I’ve had stomach pains at night (mostly) and I have heartburn and indigestion. I’ve vomited twice. It mostly happens after dinner. After I eat, I feel like I have to vomit. I wake up every night with stomach pains. Around 1-3 AM. I’m 13 years old. I think I might have a gluten free disease. Help?

  • Hi Nick. Many of your symptoms are common in conditions like gastritis, peptic ulcers and GERD (acid reflux). The symptoms tend to worsen after eating and in the early hours of the morning (around 3AM) when stomach acid production naturally increases due to the body’s 24 hour clock. The stomach pains you mention point more towards gastritis or ulcers. Antacids may provide temporary relief but these conditions can sometimes be difficult to treat on your own without prescription medication. Speak to a doctor.

  • Hi MyCanada. This can be an unusual set of symptoms but it could be related to acid reflux. Lying on your abdomen increases pressure within the abdomen and may contribute to reflux, even though the typical heartburn is not present. Increased saliva secretion (due to the reflux) may cause a fluid sound that you can hear. However, if there is some blockage then lying on your stomach could possibly increase the pressure within with middle ear. It is difficult to say for sure. Speak to your doctor who will need to assess you.

  • Slimesparkle

    Hi, I have same sort of issues too, this happens to me maybe 0-4 times a month.
    I tend to eat about 3 hours before I sleep, before I sleep I feel a bit full and i feel abit of a stomach ache that is going to come. I go to sleep on my back and then 1-2 hours later I wake up with a pain in the upper area of the stomach. It hurts sooo bad, I need help. The doctors said that I just need to eat more fruit and vegetables because I need fibre?? I don’t know but please help help. The first doctor gave me a medicine then my family doctor said to stop taking it because my body will get used to it. I did stop taking it a long time ago, but after a few months the pain came back. I hope it’s nothing serious like surgery, I’m just 14 and I am so scared. I don’t want this to keep happening, it effects school and my sleeping schedule and it worries my mom soo much.