Some people experience stomach problems every night while being relatively symptom-free during the day. There are several reasons why this occurs. While it can be related to diet and lifestyle in the evening, there are also certain conditions that worsen in relation to the body’s 24 hour cycle. Nighttime stomach problems may therefore not be imaginary but due to specific reasons.
Nighttime Stomach Complaints
Whether its a burning sensation in the stomach, pain, cramps, nausea or indigestion, we often attribute all digestive symptoms to the stomach. However, the stomach is one specific digestive organ. It is located in the upper left quadrants of the abdomen and extends to the upper middle region. Most of the stomach is tucked under the lower left rib cage.
If digestive symptoms emanate from this region then it can be attributed to the stomach. Its important to remember that the digestive organs lie close together within the abdomen. Most of us are accustomed to these symptoms occurring after eating or when hungry for us to associate it with the stomach.
The question is why may some of these stomach complaints occur or worsen at night? It is usually related to overeating in the evening, consuming alcohol and even lying flat when sleeping. The natural increase in stomach acid secretion in the early hours of the morning can also exacerbate symptoms.
Stomach complaints do not occur on their own unless there are pre-existing stomach diseases, like gastritis, peptic ulcers, an obstruction within the stomach or even serious conditions like stomach cancer. However, indigestion may affect any person even without these stomach diseases being present. The same factors that can aggravate a stomach disease can also cause or worsen indigestion.
It can be difficult to isolate abdominal or digestive symptoms to the stomach specifically. With the abdominal organs being so tightly packed in the abdominal cavity, symptoms arising from neighboring organs may be mistaken for the stomach.
Typical stomach symptoms include:
- Burning sensation, discomfort or pain in the left upper abdomen.
- Sensation of fullness (bloating) in the stomach region.
- Persistent hunger or hunger pangs.
- Nausea with or without vomiting (sometimes vomiting up blood).
- Alterations in appetite.
These symptoms tend to worsen after eating but sometimes may ease with meals. Aggravations or onset in the evening or night is a less common modality of stomach symptoms. It is important to note that stomach problems can also cause symptoms in neighboring organs. For example, excessive stomach acid production can contribute to gastroesophageal reflux disease (acid reflux) which may result in symptoms like heartburn.
Types of Stomach Problems
There are a range of stomach problems that can occur. Some of these conditions are not serious but can present with severe symptoms. Other conditions may be serious and initially present with little to no symptoms.
- Gastritis is where the stomach wall becomes inflamed. This usually occurs with H.pylori infection or the excessive use of certain drugs like NSAIDs.
- Peptic ulcer disease (PUD) is where open sores form in the wall of the stomach and duodenum. It occurs for many of the same reasons as gastritis.
- Gastroparesis is a stomach condition where there is slow movement and emptying through the stomach. It is often related to nerve problems that affects the action of the stomach muscles.
- Hiatal hernia is where a portion of the stomach protrudes into the chest. The upper portion of the stomach is squeezed through the tiny hole through which the esophagus passes to meet the stomach in the abdomen.
- Stomach polyps are abnormal growths from the stomach wall. Most of these growths are not cancerous (benign) but some can become cancerous (malignant) over time.
- Stomach cancer is one of the more serious stomach conditions. It is where a malignant growth destroys the stomach tissue and can spread to other organs.
There are other stomach conditions that should also be considered. Diagnostic investigations are usually necessary to confirm the exact stomach problem. Always consult with a medical doctor when stomach symptoms arise, persist for more than a day or two, and are worsening over time.
Causes of Nighttime Stomach Symptoms
There are a host of symptoms that occurs with the stomach problems discussed above. These symptoms often overlap and it can be difficult to make a diagnosis on the symptoms alone. There are various causes of these stomach problems. However, the following factors may be the trigger or aggravating factors for the symptoms of these stomach diseases.
Eating large meals
Dinner tends to be the largest meal for most people. There are no time constraints like a rushed breakfast or limitations in portion size with a packed lunch. It is therefore not uncommon to overeat during dinner as most people retire to bed shortly thereafter. Digestion slows when asleep which can further serve to aggravate stomach symptoms at night.
Alcohol consumption can aggravate stomach problems. Most people do not consume alcohol in the morning or during the day. However, it is not uncommon for alcohol consumers to have a few drinks in the evening. This can worsen symptoms as alcohol is an irritant to the stomach lining. The quantity and type of alcohol are also factors.
Sleeping and lying down
Digestion slows down during sleep and this may play a part in worsening stomach symptoms, especially if a person eats before falling asleep. Lying flat can also be a problem if there are underlying problems which may hamper the movement of food through the stomach. Another aggravating factor is lying flat on the abdomen while sleeping which can increase pressure on the stomach.
Activity of different organs fluctuate due to the natural 24 hour biological clock. This is known as the circadian clock. Stomach acid secretion increases between 10 PM and 2 AM. Therefore stomach symptoms may intensify during these times especially in conditions like gastritis an peptic ulcer disease (PUD).
Psychological stress can also be a contributing factor in aggravating stomach symptoms. If the stress occurs at night, possibly due to social circumstances, then it is possible that the stomach symptoms may worsen at this time. However, the role of psychological stress on stomach symptoms is largely independent of time. In other words, it can also occur at any other time of the day when the same stress trigger is present.