OpenHealth Q&A

Severe Nighttime Stomach Discomfort (18M)

For nearly five years, I've been plagued by intense abdominal pain caused by excessive gas accumulation, which results in a painful stretching sensation in my stomach. Interestingly, this discomfort arises solely during sleep or when I lie flat. Upon waking with these agonizing sensations, I find relief after about an hour of moving around during my morning routine, as the gas is expelled from my body through both ends. Two years ago, I sought medical advice and was prescribed Omeprazole, which alleviated about 80% of the pain, but some discomfort still lingers. I suspect there might be an unusual connection to my bladder. I recall two occasions when I spent a prolonged 10 hours in bed. After rising, I dealt with the same stomach issues into the afternoon, but by evening, I was struck with severe bladder pain that impaired my mobility. Although my urine consistently appeared normal and semi-transparent, during one episode, the pain felt excruciating, leading me to consult a physician. I underwent tests for both urine and stool, but they revealed no abnormalities. Luckily, the bladder pain subsided by the next day. Sleeping on my stomach occasionally provided relief, but it caused neck discomfort due to the awkward position. I often began my sleep on my stomach but would shift to my back during the night. Since relocating permanently to Sri Lanka—where I ceased taking Omeprazole—my symptoms have worsened considerably. Nights are particularly challenging, as the pain disrupts my sleep, compelling me to wander around for an hour in search of relief. I've recently consulted various doctors who prescribed different medications like Rabeprazole Sodium Delayed-Release Tablets and pantoprazole, yet I haven’t experienced any significant improvement. A few months back, I developed a technique to essentially sleep through the discomfort, allowing me to endure the effects until morning instead of waking multiple times in the night and grappling with stomach troubles. I underwent an endoscopy that yielded no significant findings, but I question the adequacy of the anesthesia used. I experienced excruciating pain during the procedure, leading me to scream and cry; even after it ended, I felt utterly drained and traumatized. Given the intensity of my reaction, I wonder if the doctor rushed through the endoscopy, which raises doubts regarding the validity of the “clean report” I received. I found that elevating my upper body with pillows while sleeping initially reduced the pain significantly, but it seems I've since developed a tolerance to this method. In a moment of desperation, I resumed taking Omeprazole, but it no longer provides the same level of relief. Moreover, about a month ago, I faced increased issues with my bladder, finding myself needing to urinate frequently. My urine has been nearly clear and non-yellow, complicating matters when a full bladder forces me to wake and deal with my stomach pain. Even after refraining from drinking water two hours prior to bedtime—which results in yellow urine during that time—I still have to wake up at night to urinate. This urine remains mostly transparent and only slightly colored, contributing to my frustration. Could this be a problem with my sphincters? I have tried eliminating starch from my diet, going to bed both fully nourished and hungry, yet none of these strategies seem to alleviate my issues. Any insights or advice on this matter would be greatly appreciated.

Answers (1)

8/25/2025, 2:11:25 AM

OpenHealth AI

I'm sorry to hear about the severe discomfort you've been experiencing. Your case presents a complex set of symptoms, including nighttime abdominal pain, gas accumulation, and challenges related to your bladder. Let's break this down and explore some potential avenues for relief and understanding.

Main Points:

1. Your nocturnal stomach discomfort and gas accumulation could be related to your sleeping position or food intake.
2. The bladder pain and frequent urination could also be a contributing factor to your discomfort.
3. Your previous medications have not provided lasting relief, and you experienced trauma during your past medical procedures.

Explanation:

The intense abdominal pain you're experiencing, especially at night, could be tied to several factors, including:

• Gastroesophageal reflux disease (GERD): This could be triggered by lying flat, leading to gas accumulation and discomfort.
• Dietary factors: Certain foods can cause increased gas production during digestion. Consider keeping a food diary to identify possible triggers.
• Bladder issues: Frequent urination, even when your urine is clear, might indicate a bladder sensitivity or dysfunction.

The fact that elevation helped initially suggests positional impacts on your symptoms. However, developing a tolerance may mean that the body is adapting and you need to explore other strategies.

Next Steps:

1. Dietary Adjustments:

   • Continue to keep a diary of what you eat and identify if specific foods make your symptoms worse. Focus on reducing foods that typically cause gas, such as beans, carbonated drinks, and certain vegetables like broccoli and onions.
   • Consider trying a low FODMAP diet under the guidance of a nutritionist to determine if certain carbohydrates are causing your symptoms.

2. Sleeping Position:

   • Try consistently sleeping on your side. This position may reduce the severity of reflux and gas accumulation compared to sleeping flat on your back or stomach.
   • Raise the head of your bed slightly if you find that helps. A wedge pillow can maintain elevation without discomfort.

3. Hydration Management:

   • Limit fluid intake in the evening to reduce nighttime urination but ensure you stay hydrated throughout the day. Monitor how your intake affects your pain and urination.

4. Medication Review:

   • Since Omeprazole and other PPIs have given mixed results, discuss with a doctor the possibility of trying medications that target gas relief specifically, such as simethicone, or other approaches like probiotics, which may help reduce gas accumulation.

5. Bladder and Gastrointestinal Evaluation:

   • Given your ongoing bladder issues, it may be beneficial to consult a urologist for a full examination, especially since you're experiencing frequent urination and discomfort. They can assess if there might be a sphincter issue or other bladder dysfunction.
   • A follow-up with a gastroenterologist might be advisable as well, to discuss your ongoing symptoms and the adequacy of the investigations you've undergone.

6. Mind-Body Approaches:

   • Consider integrating relaxation techniques or mindfulness practices, especially before bedtime, to help manage the anxiety and stress surrounding your pain and sleep disruption.

It's important to follow these steps and observe any changes in your symptoms. Keep communicating your experiences with healthcare professionals to help refine your treatment approach. Please take care, and I'm here if you have further questions or need additional support.