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Gastroenterology  (Expert Forum)
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Abdominal pain that occurs only at night
Answered by
Kevin Pho, MD - Internal Medicine
Kevin, M.D. Boston - MA
This forum is for questions regarding Gastroenterology issues such as Acid Reflux (GERD), Barretts Esophagus, Colitis, Colon/Bowel Disorders, Crohn's Disease, Diverticulitis/Diverticulosis, Digestive Disorders, IBS, Stomach Pain.
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MedHelp Member's Question

Abdominal pain that occurs only at night

by Bullylover, Apr 10, 2004 12:00AM
I have never experienced this problem before until a couple of months ago.  I work nights and sleep during the day.  This problem never occurs while sleeping during the day.  Every 2 weeks or so, on a night that I am not working, I will awaken with an upper abdominal pain just below the breast bone.  It feels like a gnawing and cramping and griping sensation.  I am not nauseated with this pain, although if I do make myself vomit, the pain subsides and doesn't occur again for another 2 or 3 weeks.  My physician has put me on Zantac 150 and so far I have not had any problems.  It has been almost 2 weeks.  I had an endoscopy done when I was 18, now 33, and it showed that I do have an acid build up around the base of my esophagus.  I have been stressed the past year.  Do you think this is acid reflux or a stomach ulcer, or what?  Any help would be greatly appreciated.  There is not any pain except for in my upper abdominal region, and sometimes burning in my stomach does take place when this happens.
Doctor's Answer

by Kevin Pho, MD, Apr 12, 2004 12:00AM
You may want to consider the various causes of dyspepsia - including ulcers, inflammation of the upper digestive tract, as well as GERD.  A repeat endoscopy or an upper GI series would be reasonable tests at this point.



I would also consider a test for H Pylori - which is a bacteria associated with ulcers or inflammation.



If those tests (i.e. upper endoscopy and H Pylori) are negative, I would consider an ultrasound to ensure there are no gallbladder problems.  Other tests to consider would be a 24-hr pH study looking for GERD as well as an esophageal motility test.



Followup with your personal physician is essential.



This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.



Thanks,

Kevin, M.D.
Member Comments (10)

by yoshi, Apr 12, 2004 12:00AM
WHAT I WANT TO KNOW IS -why does it happen at nite??

by ozark, Apr 13, 2004 12:00AM
maybe your eating habits change on the night you dont work

by tgroves469, Apr 13, 2004 12:00AM
I have the same condition.  I have always had heartburn and usually take rolaids etc. to control it.  One day after lunch I was doubled over with pain below the sternum and rolaids did not help.  Symptoms subsided after several hours and did not return until a month later.  Went to ER thought it was a heart attack.  After a complete Cardio workup, Echo, Stress, EKG, blood work they told me I was fine and to take protonix for the stomach.  After 3 months problem would come and go, had an EGD and was told they found nothing except a hiatal hernia and some acid reflux.  1 month later symptoms persist, no doctor has answers.

by tgroves469, Apr 13, 2004 12:00AM
I also forgot to mention that most days the pain and discomfort are minimal, however as soon as I try to go to sleep the problem intinsifies.  I am relegated to sleeping in the recliner but I still wake up most nights in pain that antacids or OTC pain releivers don't control.

by NGP, Apr 14, 2004 12:00AM
This sounds all to familar to me. For years, I went thru this dull ache that would intensify at night time, sometimes so strongly that I would fall alseep holding my stomach. I went thru 3 endoscopy's, numerous ultra sounds and too many years of discomfort. They even did a ultra sound on my gallbladder that came out negative. Any way, after suffering thru the nite time pain attacks that would show up once a month or so...for ten years......finally they got so bad that i could take them no more. And just two years ago, the doc sent me in again for another ultra sound on my gallbladder. And that was the culprit. I cant tell you how much better I have felt since having it taken out. From what I understand, the first time the ultra sound was done on my gallbladder, the stones were just too tiny to show up, yet large enough to cause the painful attacks. However after ten years, I had allowed it to get to a dangerous point. They ended up doing an emergency gallbladder removal. The surgery was easy , I was out the same day and eating dinner that night at the table with my family. I hate myself for not forcing them to find the problem sooner. 10 years of my life i went with that pain , and it was so unnecessary.  And just so you know, everyone does not have text book symptons with gallbladder trouble. I never did throw up, and it never did radiate thru my shoulder and spine.

I wish you luck.

by dd2482, Apr 20, 2004 12:00AM
To: Bullylover
Did you ever find out what was causing your pain?  I too am suffering from abdominal pain that primarily wakes me up in the middle of the night.  It leads to nausea and then severe vomiting.  And, like you said, once I get sick, I feel fine.  Until the next time.  So far my doctor did an upper GI and a two blood tests.  One blood test was for H. Pylori which was negative.  The second was for gastrin levels which was normal.  The upper GI found one ulcer between the duodenam and the pylorus.  They also found a hiatel hernia.  I have been taking Protonix, twice a day for 2 weeks.  Then he wants me to reduce to one a day for four weeks.  I guess he thinks that this will cure it.  However, I am still vomiting once a week.  (Which is a lot better than before.  Before it was either every night or every other night.)  Please post if you hear anything.  I posted my condition under some title like Abdominal Pain and Severe Vomiting.  dide2482

by dd2482, May 18, 2004 12:00AM
Hi,

I just thought I would share. . . . I had a sudden onset of vomiting that lasted from December 03' until this month when an upper endoscopy finally found the problem.  I too, would have severe abdominal pain, relieved only by vomiting.  First I had an upper GI which showed a hiatel hernia and an ulcer on my pylorus.  They put me on Protonix, twice a day, however the