<s>[INST] I wake up in the night with servere pains down the centre of my stomach, (from just under my ribs down to aroubd my belly button) the pain is so strong for the first few minutes I cant move or turn over. I am able to go to sleep after around 5 mins. What can cause this!? [/INST] Hello! I read carefully your query and understand your concern. A severe abdominal pain that awaken you from sleep is a complaint to be taken is consideration, it can be serious. Possible causes can include:-gastric or duodenal ulcers- gallbladder disease- pancreatitis-renal stones etc. If it was a single self limited episode that resolved then can wait to see if recurs, as long as you don't have others concerning symptom. If this severe pain persist, or you have other episodes like this one, you need evaluation. A detailed medical history, complete physical examination, abdominal ultrasound and probably upper endoscopy are needed. Hope my answer has helped. Take care. Chat Doctor.  </s>