5 Causes of Stomach Pain When Lying Down and How to Treat It

You plop on the couch or into bed after a long day ready to relax. But once you're on your back, your stomach starts to hurt. What's going on?

Lying down doesn't typically cause or worsen most stomach problems, says Babak Firoozi,MD, a board-certified gastroenterologist at MemorialCare Orange Coast Medical Center in Fountain Valley, California.

That said, there are certain conditions where your position can make a difference. Keep reading to learn more about lower abdominal pain when reclining.

Lying down after a big meal can easily worsen acid reflux or gastroesophageal reflux disease (or GERD, which is frequent reflux). "When a person lies down, the chances of the stomach contents refluxing into the esophagus goes up because you don't have the benefit of gravity," Dr. Firoozi says. (GERD could also be to blame if you're waking up with stomach pain.)

You might notice a burning sensation in your stomach, chest or throat or have sour-tasting food or liquids backwash into your throat, per the Cleveland Clinic. Over time, GERD can also cause a sore throat, chronic coughing or a feeling like there's a lump in your throat.

There are lots of things that can cause gas and bloating, including eating more fiber than you're used to and drinking carbonated beverages or even too much water. But no matter the underlying culprit, lying on your back can make the problem worse.

"When you lie down face up, it's possible that you don't have the benefit of your abdominal muscles helping to force and push the gas out," Dr. Firoozi says.

If you have a GI condition that makes you more prone to gas, like irritable bowel syndrome (IBS) or an inflammatory bowel disease (IBD) like Crohn's disease or ulcerative colitis, you might also notice that the problem gets worse from lying down, Dr. Firoozi says.

Other common IBS symptoms include abdominal cramping, diarrhea and constipation, per the Mayo Clinic. IBD symptoms may be more severe and can include abdominal pain and cramping, reduced appetite, fatigue, bloody stool or unintended weight loss, according to the Mayo Clinic. These can happen at any time though, not just when you're lying down.

If your stomach hurts but you're not sick, you may have a muscle problem. You can strain or pull a muscle in your abdominal wall from an accident or fall, sudden twisting, lifting a heavy object or even excessive coughing or sneezing, according to the Cleveland Clinic.

The soreness or aching often gets worse when you cough or engage in vigorous activity. Sometimes it's also more noticeable when you're in certain positions, including lying down, Dr. Firoozi says.

Pancreatitis, or an inflamed pancreas, typically occurs from excessive alcohol use or gallstones. It can cause severe stomach pain that radiates toward the back or the chest, and it might feel worse when you lie down.

"The pancreas sits a little farther back on the abdomen. If you're lying down, an inflamed pancreas would press on your spine and cause pain," Dr. Firoozi says.

Other pancreatitis symptoms include nausea, vomiting, a rapid heart rate, fever, swelling or tenderness in your upper abdomen and yellow skin or eyes, according to Johns Hopkins Medicine.

Persistent abdominal pain, no matter what your position, is usually a sign of an underlying condition, Dr. Firoozi says. You should let your doctor know if your stomach pain isn't easing up after a few days, or if you're experiencing symptoms including:

• Fever that lasts for more than a day or two
  
• Nausea or vomiting that lasts for more than a day or two
  
• Blood in your stool, urine or vomit
  
• Abdominal swelling or tenderness
  
• Yellowing of the eyes or skin
  
• Pain in other parts of the body
  
• Shortness of breath