Topic Overview

There are two different types of peptic ulcers. They are:

• Gastric ulcers, which form in the lining of the stomach.
• Duodenal ulcers, which form in the upper small intestine.

Both types of peptic ulcers are most commonly caused either by infection with Helicobacter pylori ( H. pylori) bacteria or by frequent use of non-steroidal anti-inflammatory drugs (NSAIDs).

The symptoms of gastric ulcers and duodenal ulcers are similar, except for when pain occurs.

• Pain from a gastric ulcer often occurs when food is still in the stomach, shortly after eating.
• Pain from a duodenal ulcer often occurs when the stomach is empty, several hours after eating, and may improve after eating. Pain also may wake you in the middle of the night.

Symptoms alone cannot be used to distinguish a gastric ulcer from a duodenal ulcer. Tests such as an endoscopy or an upper gastrointestinal (UGI) series may need to be used to find out the location of an ulcer.

Gastric ulcers often heal more slowly than duodenal ulcers. A gastric ulcer that does not respond to treatment could be cancer. Your doctor will most likely recommend a biopsy of a gastric ulcer before beginning treatment. The biopsy will make sure there is no cancer hiding in the ulcer.