What causes indigestion at night?

When you lie down after eating, gravity no longer helps keep stomach contents in place. A large or late meal can leave the stomach fuller at bedtime, making reflux and burning more noticeable. A hiatus hernia may also support reflux. Acid reflux, gastritis, a peptic ulcer or Helicobacter pylori infection can cause upper-abdominal discomfort that disturbs sleep.

Night symptoms are not proof of one condition. Note whether the sensation is burning behind the breastbone, fullness, nausea, pain under the ribs, sour fluid or coughing. Gallstones can cause upper-abdominal pain and may need a different assessment from ordinary reflux.

Leave time between your evening meal and lying down, choose a lighter meal if large portions trigger symptoms, and keep a record of foods, alcohol, smoking, medicines and sleep position. Raising the upper body can help some people with reflux; stacking pillows may bend the waist, so ask a clinician or pharmacist about a suitable approach.

If symptoms recur, discuss acid reflux medication with a pharmacist or clinician. Do not rely on frequent self-treatment without checking the cause, and do not stop prescribed medicines on your own.

Seek urgent help for chest pressure, breathlessness, fainting, vomiting blood, black stools or severe sudden abdominal pain. Arrange a review if symptoms repeatedly wake you, swallowing becomes difficult, vomiting persists, appetite falls, or you notice unplanned weight loss.

Ask whether meal timing and reflux explain the pattern, whether testing for gastritis, an ulcer or Helicobacter pylori is appropriate, and how to use any medicine safely at night.