Nighttime Stomach Pain: Common Causes and Effective Treatments

One of the most common causes of stomach pain at night is a duodenal ulcer, a type of peptic ulcer that develops in the duodenum—the first part of the small intestine. The hallmark symptom of a duodenal ulcer is upper abdominal pain that often occurs when the stomach is empty or during the night. This discomfort typically improves after eating or taking medication, making it a key indicator of this condition.

Why Does Pain Occur at Night?

The presence of excess stomach acid and rapid gastric emptying contributes to the development of nighttime pain. When the stomach is empty, acid can directly irritate the ulcerated area, causing discomfort or pain. This pattern of pain—worsening at night and easing after meals—is a distinguishing feature of duodenal ulcers.

Diagnosis and Testing

If you experience recurring upper abdominal pain at night, it's important to consider the possibility of a duodenal ulcer. A gastroscopy (endoscopic examination) is the most reliable diagnostic method. Additionally, testing for Helicobacter pylori (H. pylori) infection is essential, as this bacterium is the leading cause of duodenal ulcers.

Treatment Options

For confirmed cases of duodenal ulcers, treatment typically involves a combination of acid-suppressing medications and protective agents for the stomach lining. Proton pump inhibitors (PPIs) such as rabeprazole, omeprazole, and lansoprazole are widely prescribed and usually taken over a period of 4 to 6 weeks.

If H. pylori infection is detected, a 14-day quadruple therapy regimen is recommended to effectively eradicate the bacteria and prevent recurrence. This approach significantly improves long-term outcomes and reduces the risk of complications such as bleeding or perforation.

When to Seek Medical Help

If you're experiencing persistent or severe nighttime stomach pain, it's crucial to consult a healthcare professional for proper evaluation and treatment. Early diagnosis and targeted therapy can help manage symptoms effectively and promote healing.