Epigastric pain that occurs between 3 and 5 a.m. may be due to atrophic gastritis or may be due to other causes. In atrophic gastritis, the pain is mainly in the upper abdomen and is dull or intermittent and vague, and in severe cases, colicky or severe pain may occur. In addition to epigastric pain, pain may also occur in the back, chest and other parts of the body. It may be that eating spicy and stimulating food at dinner damages the gastric mucosa, and the pain may occur in the early hours of the morning due to the increased secretion of gastric acid and unmixed with food, which may stimulate the damaged area. Others, such as duodenal ulcers can show nocturnal pain, chronic, periodic, rhythmic and other characteristics, this is because there is a large amount of gastric acid secretion at night, and is not mixed with food, into the duodenum, directly stimulate the ulcer site of the nociceptive nerve endings, which causes severe epigastric pain, through the gastroscopy and other examinations can be diagnosed. In addition, there are other reasons can also lead to 3 to 5 am epigastric pain, it is recommended to go to the regular hospital in a timely manner, clear cause, under the guidance of the doctor for targeted treatment.