Mindy Tatera, MD, is an internal medicine specialist at Banner Estrella Medical Center.
Question: I have been doing research on ulcers, but I still don’t understand something. What is the difference between peptic, duodenal and gastric ulcers or are they the same?
Answer: Peptic ulcers refer to sores in the gastrointestinal tract caused by gastric (stomach) acid. Ulcers occur when the acid and pepsin (an enzyme which is secreted by the stomach lining) break the defenses and “eat” away at the lining of the stomach and duodenum. The involvement of pepsin has led to the general description of ulcers as “peptic”.
Both gastric and duodenal ulcers are usually peptic ulcers (meaning they are caused by stomach acid). A gastric ulcer means that the ulcer is in the stomach lining, while duodenal ulcer means that the ulcer is in the lining of the duodenum, which is the upper part of the small intestine. Duodenal ulcers are the more common type. Ulcers can affect all ages.
There are some other types of ulcers that are not peptic ulcers (not caused by stomach acid), but they are rare. These include ulcers caused by diseases such as cancer, Crohn’s disease or Bechet’s disease.
The most common symptom of peptic ulcers is pain or a burning sensation in the upper abdomen, or sometimes, the lower chest. The pain usually comes and goes. Other symptoms include bloating, nausea, and vomiting. Food may either worsen or relieve the pain, the latter being more common in duodenal ulcers.
Most peptic ulcers are caused by infection with a bacterium called Helicobacter pylori. The frequency of infection is higher in duodenal ulcers. Helicobacter pylori produces substances that weaken the stomach lining’s protective mucus. If a peptic ulcer is found, the infection is treated with antibiotics. Use of anti-inflammatory drugs (such as aspirin and ibuprofen) is another important cause of peptic ulcers. Risk factors also include smoking, heavy alcohol use and stress. Other medications used in the treatment of ulcers include acid reducers and those that cover and protect the ulcer site. Evaluation by a trained health care professional is necessary for accurate diagnosis and treatment.