When does the abdominal pain start?

Sudden onset of fasting pain in the upper abdomen at night is often an indication of an ulcer in the duodenum (also: duodenal ulcer). In most cases, eating provides an improvement in the symptoms. Biliary colic may also occur at night.

In medicine, colic is defined as a very strong, periodically increasing and decreasing pain. In the abdomen, colic usually occurs as a result of a gallstone condition: the gallstones exert pressure on the bile ducts. Due to the development of gallstones, such colic can occur especially after very fatty meals.

Abdominal pain, especially in the morning, can be a sign of an ulcer in the duodenum, just like pain in the fasting abdomen at night. In addition, the abdominal pain can be caused by food taken with breakfast in the morning. For example, lactose intolerance is often hidden behind the morning stomach pain, which is triggered by the milk in coffee or the milk in muesli and then causes discomfort. A sensitive stomach or irritable bowel syndrome can also be triggered by the morning coffee and cause stomach ache. In most cases, a change in breakfast habits can provide more clarity.

Associated symptoms

The accompanying symptoms can vary greatly in intensity and severity with the cause of the abdominal pain. Common symptoms that indicate indigestion and malfunction of the digestive system are diarrhoea, constipation, vomiting, nausea, fever, loud bowel sounds, abdominal cramps and flatulence. However, more serious diseases can also be behind the abdominal pain, which in turn can be accompanied by severe symptoms.

This can lead to biliary colic, back pain, weakness with fainting, severe abdominal pain, intestinal obstruction and blood in the stool. Depending on the location of the bleeding, fresh blood, coagulated blood or black blood in the stool may be found. Rarely the pain radiates to the back, groin or chest.

Abdominal pain and nausea initially indicate irritation or inflammation of the gastrointestinal mucosa. Infectious agents, spoiled food, food intolerances or diseases of other abdominal organs can initially cause abdominal pain and nausea, and later abdominal cramps, vomiting and diarrhoea. Diseases of the liver can also lead to nausea and, in the case of swelling of the liver or pressure on other organs, can also cause abdominal pain.

If the vomiting and diarrhoea persist for a longer period of time, care should be taken to ensure a sufficient supply of water and electrolytes despite the nausea. Heartburn is one of the most common causes of abdominal pain today. This is caused by an overproduction of gastric acid which returns to the oesophagus where it causes small inflammatory reactions and irritation of the mucous membrane.

The typical burning sensation is promoted by fatty foods, coffee, alcohol and nicotine. In the long term, heartburn can cause serious consequential damage. Permanent contact between the oesophagus and the strongly acidic stomach acid causes the mucous membrane to change, which can lead to a considerably increased risk of cancer. If heartburn occurs several times a week, a medical examination and an initial therapy in the form of a change in diet should be carried out.