Waking up in the middle of the night with abdominal pain may be caused by physiological factors such as improper diet, excessive dieting, or considered to be caused by acute appendicitis, acute gastroenteritis and other diseases. 1. Physiological factors: If you consume too much cold, spicy, stimulating food before going to bed, or excessive dieting for a long time, it may lead to gastrointestinal spasms, abdominal pain, manifested in the middle of the night, waking up with abdominal pain. This kind of situation is a normal phenomenon, daily reasonable diet can be relieved. 2. Acute appendicitis: Acute appendicitis is caused by blockage of the appendiceal lumen, pathogenic microbial infections, appendiceal fecal stone, appendiceal tumor and other factors. Patients may have sudden abdominal pain, nausea, vomiting and other symptoms, manifested as waking up in the middle of the night with abdominal pain. 3. Acute gastroenteritis: Acute gastroenteritis may be caused by pathogenic microbial infection, eating cold and irritating food, seafood allergy, alcoholism and other factors. Patients manifested as abdominal pain, diarrhea, nausea, vomiting, etc., and some patients may wake up in the middle of the night with abdominal pain. There are many reasons for waking up with abdominal pain in the middle of the night, and it is recommended that patients go to a regular hospital to find out the cause of the disease.