Epigastric pain in the middle of the night may be a symptomatic manifestation of certain diseases, such as cholecystitis, duodenal ulcer, intestinal spasms, etc. When persistent or progressive pain occurs, one should consult a doctor promptly to identify the cause. 1. Cholecystitis: chemical inflammation caused by gallbladder stones, infection, obstruction of bile drainage, etc. The clinical manifestations of patients are mainly epigastric pain, which mostly occurs after eating fatty meals or at night, and may be accompanied by nausea and vomiting, and in some patients, it may be combined with infected septicemia, with symptoms of high fever and jaundice. 2. Duodenal ulcer: the duodenum is attacked by high gastric acid and high protease, and the mucous membrane is damaged, which can lead to ulcer. Some patients may have no obvious symptoms, some patients may have recurrent epigastric pain, often at night or when feeling hungry, which can be relieved after eating. 3. Intestinal spasm: due to hunger in the middle of the night, localized cold, or intestinal parasitic infections, indigestion and other factors, so that the intestinal wall smooth muscle contraction caused by the umbilical cord or epigastric pain and discomfort of the symptom, the pain is mostly paroxysmal, usually can be relieved on their own, but can be repeated episodes. In addition, acute gastritis, acute cholangitis and other diseases can also cause a burst of pain in the left epigastric symptoms, but this symptom alone is not enough to diagnose the disease, should be timely consultation, a clear diagnosis, and comply with the doctor’s instructions for treatment.