Diagnosis
To diagnose nocturnal abdominal pain, the doctor uses the same methods as for upper abdominal pain of any kind. At the beginning there is the questioning of further complaints, the taking of medication and more. This is followed by a physical examination.
Depending on the suspected illness, a blood test, an abdominal ultrasound or a gastrointestinal endoscopy can then be performed. If food intolerance or allergy is suspected, the person concerned is often asked to keep a diary about food and pain. If an emergency such as a heart attack or a gastric perforation is deemed possible, the patient is usually examined and treated in hospital as an emergency.
Associated symptoms
Depending on the causative illness for the nightly stomach pain, a number of accompanying symptoms are possible. Almost always nightly pain is accompanied by sleep disturbances due to frequent waking up, which is why it is recommended to consult a doctor for a quick clarification if the symptoms occur repeatedly. Food intolerances or incorrect eating habits can cause diarrhoea, nausea, vomiting and heartburn.
The reflux disease is usually accompanied by heartburn, which can be felt behind the breastbone and in the throat. Ulcers in the stomach or intestines can lead to nausea, discomfort in the stomach area and blood in the stool. The blood in the stool is often not red, but pitch black due to the passage through the intestines.
If a bleeding or an inflammation of the gastric mucosa lasts longer, anaemia can occur. This manifests itself through general weakness, tiredness, listlessness and paleness. If a heart attack is responsible for the symptoms, it can also lead to chest pain, shortness of breath, circulatory problems and great anxiety.
If the pain is very severe and the abdomen is tense, a condition requiring surgery such as a perforation of the stomach may be present. Vomiting in connection with stomach pain at night can have various causes.Often the stomach is simply irritated because of a food intolerance or a meal that is too large, too greasy, too sweet or spicy, or an excess of alcohol, thus triggering vomiting. If the vomiting stops quickly, there is no need to worry.
If it lasts for a long time, occurs repeatedly together with stomach pain for days or weeks or contains blood, a doctor should be consulted to detect and treat diseases such as a stomach or small intestine ulcer or inflammation of the mucous membrane of the stomach. To relieve the nausea, over-the-counter tablets or suppositories with anti-emetic agents can be used. Sweating is not uncommon for any kind of pain.
Activation of the involuntary nervous system activates the body, which can lead to sweating, a raised pulse and increased blood pressure. If the sweating is accompanied by circulatory problems such as trembling, blackening of the eyes or fainting, anemia may have been caused by a disorder of the stomach. In this case an emergency doctor must be called.
Heavy night-time sweating, where even pyjamas or bed linen have to be changed because of the wetness, is to be taken seriously: it can generally indicate a tumor disease and, in connection with stomach pain, stomach cancer – especially if weight has been lost unintentionally and an unclarified fever exists. Back pain is not typical in connection with nocturnal stomach pain, but it does occur in rare cases. In principle, all painful diseases of the stomach or upper small intestine can cause pain in the middle back. Back pain in connection with pain in the stomach area is also possible in the case of inflammation of the pancreas, a heart attack or diseases of the abdominal artery. It should be noted that both back and stomach pain are very common complaints and can coexist without being causally related.
