Does Your Stomach Hurt in the Morning? Here Are Tips That Can Help

Waking up with stomach pain is a difficult way to start the day. And while most stomach pain is related to mild to moderate causes, if you’re waking up frequently wondering why your stomach is hurting in the morning, it may be a sign of a more serious condition. Read below to understand the common causes of stomach pain, how to deal with stomach discomfort, and when it may be time to seek medical attention.

Common causes for stomach pain in the morning

What is referred to as 'stomach pain' can actually include pain felt anywhere between your chest and groin (also known as abdominal pain). Therefore, the causes of morning stomach pain can include a wide variety of conditions, ranging from acute to chronic.

Digestive disorders

Irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD) (including Crohn’s disease and ulcerative colitis) are common digestive disorders that can cause uncomfortable symptoms such as abdominal pain. Symptoms tend to be worse in the morning due to naturally high levels of inflammatory stress hormones at that time as the digestive tract starts to become active again. Additionally, if eating is one of the first things you do in the morning, the act of eating and what you eat can have an effect, particularly because IBS and IBD can include several food intolerances.

The causes of IBS and IBD are not fully understood, but genetics and environmental factors (i.e., stress, diet) are thought to play a role, as well as immune function, specifically for IBD. Women are more likely to develop IBS and Crohn’s, while men are more likely to be diagnosed with ulcerative colitis.

Acid reflux

Acid reflux is when acid from inside your stomach flows into your esophagus, causing heartburn, chest discomfort, burping, and/or difficulty swallowing. If acid reflux symptoms happen more than twice a week, you may have an acid reflux disease known as gastroesophageal reflux disease (GERD).

Acid reflux is exacerbated by eating late at night and lying down. Digestion also slows down while sleeping, which may be why reflux can be bothersome in the morning. Additional factors that affect acid reflux are:

• Eating large meals
• Eating certain acidic (citrus, tomato products, chocolate, mint), spicy, or fatty foods
• Drinking alcohol and carbonated or caffeinated beverages
• Smoking
• Pregnancy
• Obesity

Peptic ulcer disease

Peptic ulcer disease is a disease in which sores develop on the inside of your stomach lining and the upper portion of your small intestine. This occurs due to increased stomach acid or damage to your protective mucous barrier. Some people with peptic ulcer disease have no symptoms at all. Others may experience pain that comes and goes. An empty stomach, which is typical after an overnight fast, can sometimes worsen symptoms.

Common risk factors for development include H. pylori infection and regular use of NSAIDs (aspirin, ibuprofen) or other medications like SSRIs. Stress can also play a factor.

Stress and anxiety

Stress has both short- and long-term effects on digestive health. Excessive stress is tied to the development of gastrointestinal disorders, including IBS, IBD, peptic ulcer disease, and GERD, as well as difficulty managing these conditions. Stress also initiates a flight or fight response, which slows down non-essential body systems like digestion to allow for more blood flow to your heart, lungs, and muscles. That means that in response to stress, a slowed digestive system can cause stomach pain, ingestion, heartburn, and nausea.

Constipation

Constipation is defined as having hard and dry stools or passing fewer than three bowel movements in a week. In the morning is when your bowels are most active, but if you have difficulty or cannot pass a bowel movement, you're likely to experience abdominal pain and cramps.

Constipation is often the result of changes to diet, physical activity, routine (for instance, when traveling), and stress. However, certain medications like antidepressants, prescription pain medicines, antacids, and iron supplements, as well as certain conditions like hypothyroidism, IBS, pregnancy, and diverticulitis, can also contribute to more chronic constipation.

Indigestion

Indigestion is a general term for upset stomach and gastrointestinal symptoms such as bloating, gas, stomach pain, nausea, or fullness, which can be tied to the underlying medical conditions discussed above but most often is related to lifestyle:

• Eating too quickly or overeating
• Eating specific foods (fried, fatty, spicy, acidic)
• Consuming alcohol or caffeine
• Smoking
• Having elevated stress levels

Dietary habits

As mentioned, certain foods can irritate your stomach, or you may experience stomach pain as a result of specific food sensitivities. For instance, lactose intolerance and gluten sensitivity are two common culprits for stomach discomfort, which can be an issue for someone who enjoys dairy or wheat-based cereals and toast for breakfast. Additionally, overeating before bedtime or consuming heavy meals for your evening meal can lead to stomach pain when you wake up due to a disruption in digestive processes.

Symptoms of stomach pain in the morning

Waking up with stomach pain can feel different for each individual. It may feel dull, achy, burning, gnawing, or crampy. You may feel it all over (generalized), localized to a certain area, constant, or come in waves (colicky). It may also be accompanied by other symptoms like nausea, vomiting, or diarrhea.

Treatment of stomach pain

The intensity of symptoms does not always reflect the seriousness of the cause of the pain. However, you should always take note of any pain that is new for you, particularly if the pain starts occurring more often, gets stronger over time, or occurs with a fever.

OTC medications

For some people, over-the-counter (OTC) medications, such as those noted below, can help reduce stomach pain. However, always be sure to discuss your symptoms with a healthcare provider first. Especially since some commonly used pain medications like NSAIDs can actually irritate your stomach lining further.

• Medications with simethicone (example: Gas-X) for gas pain or bloating
• Antacids for acid reflux or indigestion
• Stool softeners or laxatives for constipation
• Probiotics to help promote overall gut health

Dietary changes

Stick with easy-to-digest foods and avoid triggers that may make symptoms worse or digestion difficult. For instance, you may want to limit:

• Acidic foods
• Spicy foods
• Caffeine
• High-fat or greasy foods
• High-fiber foods
• Alcohol
• Carbonated beverages

In addition, avoid or minimize any known food triggers. For instance, for someone with IBS, a healthcare professional may suggest following a specific dietary pattern, such as a low-FODMAP diet. If you have questions about how dietary interventions can help manage your symptoms, be sure to reach out to your healthcare professional or someone like a registered dietitian specializing in nutrition.

Home remedies

There are also some home remedies that you could try to help minimize morning stomach pain symptoms. Keep in mind that if overused, these strategies may actually worsen symptoms, so consult with your healthcare provider first, or alternatively, consider trying some of the prevention strategies discussed in the next section.

Heat is a natural way to loosen muscles and provide pain relief. Try soaking in a warm bath or applying a heat pad to your abdomen.

Studies have demonstrated abdominal massage as a way to stimulate bowel function and decrease pain and discomfort. It is most appropriate for someone experiencing constipation and should not be attempted if you are pregnant or have an inflammatory bowel disease. The technique involves massaging your abdomen in a clockwise position to follow the direction of your intestines.

How to prevent stomach pain in the morning

Because many causes of stomach pain are affected by lifestyle, there are several preventive actions you can take to keep from waking up with stomach discomfort:

• Promote digestive stimulation through regular physical activity. Aim for 30 minutes of physical activity most days of the week. Light activity for 10–15 minutes following a meal is particularly helpful in promoting digestion.
• Reduce stress as much as possible.
• Focus on adequate hydration for healthy consistency and frequent stools. The general rule of thumb is eight 8-ounce glasses of water per day.
• Be mindful of eating fried and high-fat foods or large meals close to bedtime. If you do, try elevating your head when lying down.
• Limit foods that trigger symptoms of indigestion, reflux, and similar.
• Try eating more slowly.
• If diagnosed with a specific digestive disorder or condition, follow your healthcare provider’s management recommendations.

When to seek medical help?

While there are instances of mild stomach pain, even mild stomach pain must be taken into consideration. It is important to monitor and consult with your healthcare provider for further assessment, particularly if the pain is not resolving. It could be a sign of a potentially life-threatening condition or one that requires immediate attention, such as appendicitis, a bowel blockage, gallstone, liver or kidney disease, or even a heart attack. If you are experiencing stomach pain combined with any of the following symptoms, please seek medical help right away:

• Blood in your stool, urine, or vomit
• Difficulty breathing
• Vomiting with the inability to pass stool
• Fever
• Jaundice (yellowing of the skin, eyes)
• Abdomen or stomach that is tender or tight to the touch
• Pain in any other part of the body (such as between the shoulder blades or in the chest)

Your provider will assess the location of the pain, type of pain, intensity, duration, and any other symptoms to determine proper treatment. You may also be ordered to do a urine, blood, or stool test, along with imaging tests to detect any abnormalities.

While some stomach pain in the morning can be caused by lifestyle factors and minimized by lifestyle interventions, it's important to pay attention to the signs and symptoms you are experiencing and to reach out to your health professional with concerns.