Upper abdominal pain at night


The upper abdomen comprises the area between the lower costal arch and the navel. Pain in this area can be the cause of numerous illnesses, most of which are harmless and usually easy to treat.


The Symptoms the upper abdominal pain that occurs at night is just as diverse as its causes. The pain quality, i.e. how the pain feels, the pain intensity, i.e. how strong the pain is felt, duration, location and time of occurrence are also important clues for the cause of the corresponding pain.

Furthermore, the pain can be accompanied by other symptoms, such as Bloating, Flatulence, loss of appetite, acid regurgitation, Diarrhea, vomiting, skin changes in the sense of Rashes, Weight changes, Fever, chills and general Changes in stool and urine, occur.

Burning painthat extend from the upper abdomen to behind the breastbone are typical of heartburn. When lying down, including at night, the pain often intensifies, as the stomach acid responsible for the inflammation of the mucous membranes can more easily pass through the esophagus. The complaints are exacerbated, for example, with previous fatty meals.

Spasmodic painsymptoms of a., which can occur after, with and occasionally completely independently of meals Irritable stomach or one Gastrointestinal infection (gastroenteritis) be. Accompanying symptoms with irritable stomach are Bloating, Flatulence and nauseathat can last well into the night, especially if you eat too large portions of food before going to sleep. The gastroenteritis is typically from diarrhea, Vomit and Loss of appetite accompanied. Viruses are usually the cause of the disease, which is why you have to "sit out" more or less. Especially with an acute infection, those affected feel pain and the urge to go to the toilet even at night, but this subsides as the disease progresses.

Immediately or during the Ingestion Occurring, pressing to stabbing pain that subsides during the day or night can be an indication of a stomach ulcer. Fasting pain, which occurs particularly at night or in the early morning hours, is typically found with inflammation of the stomach lining (gastritis). The quality is pungent accompanied by loss of appetite and occasionally nausea. The pain is aggravated by external pressure on the epigastric region.

In rare cases, the cause of the nocturnal fasting pain can also be one Cancerous tumor be in the duodenum. The improvement of the pain through food intake is typical.

Very strong, labor-like (upward and downward flaming) cramping pains, which wrap around the upper abdomen like a belt, occur as part of a pancreatitis. The pain can be so severe that those affected cannot rest at night. Typical of this disease are also bluish-greyish spots on the flank and around the navel, as well as flatulence with a feeling of fullness.

Spasmodic abdominal pain, accompanied by diarrhea and constipation, as well as dark stool discoloration (tarry stool), can be signs of colon cancer. However, this type of bulging pain also occurs inflammatory bowel disease, which also includes Crohn's disease and which often torments those affected into the night.

Diffuse dull pain that cannot be precisely localized, accompanied by a drop in performance, loss of appetite, a Yellowing of skin and Eye clearing are possible symptoms of destruction of the liver, the so-called cirrhosis of the liver. Due to the sleep disorders, those affected feel the pressing pain, especially at night.

From Pain radiating from back to upper abdomen can be signs of an aortic aneurysm. The pain occurs very suddenly and can be paired with paresthesia in the legs. (Important : there is a need for action faster and you should not hesitate to consult a doctor if in doubt!).

Oppressive radiating to the left arm or stomach Chest pain in the late night and especially in the early morning hours out of complete well-being are possible indications of an acute heart attack. Women in particular suffer from atypical symptoms such as abdominal pain when they have a heart attack. Here, too, there is a need for action more quickly and there should be no hesitation in consulting a doctor in case of suspicion.

Spasmodic upper abdominal pain

Spasmodic upper abdominal pain come about by tensioning the muscles in the abdominal area. Existing pain is aggravated by the tension. This happens reflexively, i.e. automatically in response to an internal stimulus, such as an inflammation of the gastrointestinal tract.

Short-lasting, cramping pain at night with an additionally distended stomach are usually the cause of too many Gas in the stomach and intestinesespecially if you eat gas that is bloody during the day or before going to bed, such as cabbage vegetables. After the wind is gone, the pain disappears quickly.

Cramp-like pain that occurs more frequently at night can result in a Disorder of passage in the gastrointestinal tract Clues. The body is particularly busy digesting when it is resting. If there is an obstacle in the course of the intestine, such as a kinking of a loop of intestine, often in the context of adhesions after abdominal operations (Bride), Constrictions caused by chronic inflammatory bowel diseases, such as Crohn's disease or a tumor growing into the intestine, stool can only pass through the constricted intestine with difficulty. The intestinal muscles work harder to push the stool past the obstacle, which explains the cramping pain. The disease is technically called Ileus designated.

Children can also benefit from one Ileus and the accompanying, sudden cramping abdominal pain, the causes differing from those of adults. In the case of the little ones, for example, intussusception in which a section of the intestine turns into the one in front of it leads to a passage obstacle in the digestive tract.

A harmless cause of (Upper) abdominal cramps in the night is one Gastrointestinal inflammation. Especially at the onset of the disease, those affected are accompanied by the pain diarrhea, nausea and Vomit, plagued. Occasionally, those affected also develop a fever. The cramp-like pain and diarrhea come about through increased intestinal activity, as a reaction of the body to "flush out" the responsible pathogen. Since the stomach is also located in the upper abdomen, this can also be the cause of cramp-like nocturnal pain.

Cramp-like pain empty stomach speak for an inflammation of the gastric mucosa, which as gastritis referred to as. If the gastric mucosal inflammation is long-lasting, it can develop into a stomach ulcer, which presents with similar symptoms.

Sudden cramping pain in the left upper abdomen, which occur like colic (the intensity of pain increases and decreases alternately), especially in middle-aged women Gallstones that slipped into the bile duct and got stuck there. The biliary tract muscles try to push the stone out through increased contractions. The friction of the stone leads to inflammation of the affected biliary tract, which increases the intensity of the pain. The cramps typically slow down Ingestion tobecause the bile is used for digestion. However, since the pain is often felt to be very strong, it often lasts into the night, which keeps the person concerned awake.

Strong spasmodic upper abdominal pain with its maximum in the left lower abdomen also occurs as part of an inflammation of the pancreas (Pancreatitis). Typical is the feeling of the sick that the Pain, as a Belt around the belly lay. In this context, those affected have often been drinking alcohol for many years.

Sharp upper abdominal pain

Sharp upper abdominal painthat occur at night can occur Food intolerance Clues. The most common intolerances are those against Milk sugar lactose, the Gluten protein and against the fructose Fructose. For most of those affected, this also occurs Stool changes in the form of diarrhea or constipation, and very often nausea.

The gastric mucosal inflammation can present itself in addition to the cramp-like, often in combination with sharp pain. It typically occurs on an empty stomach, especially at night. If the gastric mucosal inflammation is left untreated, it can develop into a stomach ulcer over the years with the same night-time convulsive, stabbing symptoms.

The irritable bowel is also often presented by combined, stabbing upper and lower abdominal pain that recur at different intervals. In addition, also occur here frequently diarrhea or constipation on. The cause is largely unclear; however, this is typical Reinforcement or the occurrence at stress and the improvement of complaints after bowel movement.


nausea is a common one Concomitant symptom for nocturnal epigastric pain. A cause cannot always be found, because epigastric pain often occurs with nausea as part of one Irritable stomach or intestines on. Women are particularly affected, usually during times of stress. It is assumed that the body does not come to rest properly due to the stress and that digestion is slow to get going, which results in delayed gastric emptying. In addition to the stabbing and spasmodic epigastric pain and nausea, the irritable stomach presents itself Bloating and Eructation.

Sudden nausea that lasts into the night is also a frequent accompanying symptom in the context of a gastrointestinal infection (gastroenteritis). Children are particularly often affected. In certain months of the year, different pathogens are typical triggers. The one of the most common and well-known Norovirus infection occurs all year round, for example, while rotavirus infection occurs mainly in the spring months of February to April.

Upper abdominal pain at night in combination with nausea also occur with the not uncommon inflammation of the gastric mucosa. She is through one excessive stomach acid production conditionally, which among other things by stress, alcohol, excessive Coffee consumption and Smoke is increased.


The causes resemble those of Upper abdominal painthat occur during the day. However, nocturnal upper abdominal pain speaks, among other things, for a strong pain intensity, often associated with a high level of suffering on the part of those affected, since restful sleep is only possible to a limited extent. In addition, it should always be noted that many people Pain in the night perceive differently than they do during the day. Plenty of distractions and pursuits are available during the day so Pain in its intensity usually perceived weakerthan at night, when the body "has the opportunity" to focus on the potential problem when it is at rest. Another peculiarity of the upper abdominal pain that occurs at night or in the early morning hours is that it falls under the so-called "fasting pain". This means that the pain only occurs or intensifies at the point in time when the digestive tract, in particular the stomach, is largely empty. The causes of upper abdominal pain at night mainly include symptoms of the Gastrointestinal tract, how Inflammation, Food intolerance, heartburn and occasionally malicious ones Tumor diseases.

In addition to the digestive tract, the cause of the upper abdominal pain can also lie elsewhere in the body. The Pain project into the upper abdomen, so to speak, and can be a sign of a life-threatening emergency.

Also diseases of the lung, how Pleura- or Pneumonia can cause upper abdominal pain, especially children, at night and during the day. A life-threatening emergency for adults, which is accompanied by nocturnal upper abdominal pain, is, for example, an aortic aneurysm (tear in the main artery) or a heart attack.

Upper abdominal pain on the right

Upper abdominal pain at nightn are very common on the right side localized, as there are many organs that can cause problems in this area. These are above all liver and Gallbladder. Gallbladder inflammation usually occurs in combination with a fever. Those affected, usually women, also suffer from it almost always Gallstones. In the majority of cases, these are also the trigger for the inflammation. The stones irritate the gallbladder lining, making it easier for bacteria to enter. The severe pain that lasts the night usually radiates to the right shoulder. The (deep) inhalation and coughing is clumsy and painful.

In rare cases, inflammation of the gallbladder can also occur in the context of blood poisoning, after major trauma such as car accidents and after severe burns. Gallstones can cause extreme pain in the right upper abdomen even without accompanying inflammation.
Small stones in particular slip easily into the bile duct and get stuck there. It comes to wavelike, sometimes very severe pain.
These symptoms are called Biliary colic designated. Here is one too Radiation of pain in the right shoulder typical.

Like the gallbladder, the liver can also be affected by inflammation. This is known as hepatitis (hepar = liver).
A hepatitis also causes Pain in the upper right abdomenwhich cannot be precisely localized there, i.e. are diffuse. You can also stop into the night.
The accompanying symptoms are usually so unspecific that the inflammation is not infrequently recognized late.
In addition to diffuse pain, they include, among others Headache, joint pain and muscle pain, persistent fatigue and Performance kink, as well as changes in taste and loss of appetite.

The inflammation continues and goes into one chronic phase over, it comes to Yellowing of the skin and the white of the eyes, to one darker color of urine and one Lighten the bowel movements, as well as to itching, nausea and Vomit. The disease is triggered by various viruses that come under the term Hepatitis viruses be summarized.

With some viruses, especially hepatitis C.-Virus a chronic course of liver inflammation is almost unstoppable.
More rarely, bacteria or parasites are the cause of the problem. Besides infections can be more permanent and excessive Alcohol consumption, Drug abuse (especially paracetamol) and metabolic diseases (Wilson disease) Damage the liver in such a way that permanent pain in the right upper abdomen can also occur here, sometimes even at night.

Upper abdominal pain on the left

The spleen and pancreas are important organs on the left side of the abdomen. The spleen is surrounded by a hard capsule. If the spleen swells up as a result of various diseases and puts this capsule under tension, this leads to sometimes severe pain, which can often appear suddenly and at any time and persist at night and during the day. So can the spleen, like the heart Heart attacks suffer when a vascular clot clogs important blood vessels supplying the organ. In addition to severe pain, leave frequently Vomiting blood and dizziness the sick do not come to rest.

Due to blood cancer (leukemia), infections and Autoimmune diseasessuch as butterfly lichen (lupus erythematosus), the spleen can also be damaged, typically with creeping pain in the left upper abdomen, which particularly torments those affected at night.

Inflammation of the pancreas causes permanent pain, even at night, which is like a belt around the stomach and has its maximum pain in the left upper abdomen. In addition to the pain, those affected suffer from nausea, Vomit and Flatulence. The pain can be so severe that the intestine pauses its work and in the worst case it can result in an intestinal obstruction.

Pain caused by Radiate back into the left upper abdomen could be signs of a kidney stone that has slipped into the ureter, blocking it. Here, too, no pain maximum can be classified during the day or at night. The pain occurs at both times and begins when the stone enters the ureter and its narrowing. It is a colic pain that occurs in waves, that is, its intensity flares up and down. It is very painful, so sometimes too nausea and Vomit occurs. Women in particular should take pain in the left upper abdomen, especially in combination with Chest pain and Shortness of breath think of a heart attack and if you suspect, see a doctor as soon as possible.

Upper abdominal pain in the middle

Upper abdominal pain at night, which are located in the middle, occur in the context of an inflammation of the gastric mucosa, a stomach or duodenal ulcer. The latter two, especially in the case of long-standing pain symptoms. The pain is relieved for many people with food, especially with duodenal ulcer. Pain caused by a heart attack can also radiate into this epigastric region.

Flatulence during night epigastric pain

Upper abdominal pain that occurs at night and is accompanied by flatulence can have very different causes. If they occur after consuming certain foods, this may be the cause. Flatulence and abdominal pain, for example, are often described after eating beans, high-fat food, onions and fresh bread that is still warm. Nocturnal gas and abdominal pain can also be an indication of a food intolerance. Lactose intolerance is widespread. Lactose is found in dairy products. If flatulence and abdominal pain occur again and again after consuming milk or cheese in the evening, for example, this can be an indicator of lactose intolerance. You can then either take tablets before eating, which improve the metabolism, or you can use lactose-free dairy products.

Consuming carbonated drinks such as cola or mineral water in the evening can also lead to nighttime abdominal pain with flatulence. Such drinks should then be avoided. Alternatively, teas or still water are recommended. Another possible cause of the symptoms is the so-called reflux disease. Especially at night, gastric acid refluxes into the esophagus. It is often associated with nightly heartburn and burning behind the breastbone. Sleeping with your upper body elevated can help. In rarer cases, ulcers in the stomach or duodenum cause nocturnal gas and abdominal pain.

Chronic pancreatitis can also be the cause. The cause in this case is that not enough digestive enzymes are produced. Medicines can be taken here that contain the necessary enzymes, including the symptoms are usually significantly reduced. If the symptoms occur during treatment with antibiotics, the cause can usually be found here. The symptoms then usually go away after the therapy has ended. It is not uncommon for pregnant women to complain of recurring flatulence. The cause here can be a slight decrease in bowel activity (indolence).

Upper abdominal pain during pregnancy

Pregnant women often suffer from epigastric pain both during the day and at night, especially in an advanced month of pregnancy.

The Child movements in the womb there are also internal organs of the pregnant woman, such as the liver, which causes short-term upper abdominal pain in women.
The rest times of the child in the womb do not always match those of the expectant mother, which is why short-term pain can also occur at night.

Caution is advised if not localizable Upper abdominal pain in combination with other accompanying symptoms, how high blood pressure and extremes Water retention (Edema), especially in the legs.
This can be the first indication of the onset of pregnancy poisoning, technically as pre-eclampsia designated to be. Persistent Upper abdominal pain with maximum in the right upper abdomen that regardless of child movements should therefore occur from Gynecologist to be clarified.
As the child and the growing uterus press on the stomach from below, pregnant women in the late months of pregnancy often suffer from heartburn, which is often made worse at night by lying down.

Upper abdominal pain when lying down

When lying down, heartburn or a worsening of pre-existing pain mainly occurs. The stomach acid can flow more easily into the esophagus and provoke the corresponding symptoms, such as burning behind the breastbone and acidic belching.

Read more on the topic: Abdominal pain when lying down


In many cases, a diagnosis can already be made during a medical consultation based on the typical localization of pain and the appearance of certain accompanying symptoms. Especially with simple ones Gastrointestinal infections no further examinations are usually necessary. Physical exams like that Palpation and listening of the abdomen often contribute to confirming the diagnosis. As a simple, quick and safe means for those affected, the examination using an ultrasound device can provide the doctor with important additional information about the cause of the disease.

So can, among other things Gallstones, Gallbladder and Inflammation of the pancreas can be seen on the ultrasound image. In rare cases, especially if there is a suspicion of an intestinal obstruction, stone disease (especially kidney stone) or damage to internal organs, further imaging such as x-rays CT (Computed tomography) or MRI (Magnetic resonance tomography) essential for the correct therapy and the further procedure.

A Esophagus-, stomach- and Duodenal imaging is used in the case of persistent heartburn and if there is a suspicion of serious gastric mucosal inflammation or tumor diseases in this area and is usually used as part of a light sleep anesthesia carried out so that you do not notice anything from the examination. If you suspect one Heart attack become blood values examined and a EKG written.


The therapy depends on the triggering cause. They are only briefly described here. If you have a gastrointestinal infection, you have to wait until the body has fought it itself. A sufficient supply of fluids and minerals must be ensured. Preparations suitable for this purpose are available in the pharmacy.

At heartburn and / or inflammation of the gastric mucosa, preparations are used that inhibit the production of gastric acid and thereby give the mucosa the opportunity to recover and heal. During this time, the healing should be supported excessively coffee, Smoke, alcohol, as well as on acidic and very fatty dishes are avoided.

Will the pain go through Gall or kidney stones first, an attempt is made to remove the stone from the clogged passage with the help of relaxing medication. If this does not succeed and the pain persists, the stone is removed as part of a minor intervention, usually with a camera probe.

In the event of a heart attack, under a Cardiac catheterization the closed vessel is examined under fluoroscopy, opened and in many cases by means of a wire mesh (Stent) splinted so that it does not close again immediately. If more than 3 vessels or one of the main vessels of the arteries supplying the heart are affected, a Bypass surgery should be considered. A Rupture of the main artery (Aorta) needs quick treatment. Here, too, an attempt is made to splint the vessel with the help of a plastic wire mesh, similar to the procedure for a heart attack.