What are gastric and duodenal ulcers?
Gastric and duodenal ulcers are two kinds
of peptic ulcers. A peptic ulcer is a sore that’s on the inside of the stomach
lining (gastric) or the upper part of the small intestine (duodenal).
A person can have one or both ulcers at
the same time. Having both types is known as gastroduodenal.
How do symptoms differ?
One way of
telling if you have a gastric or duodenal ulcer is figuring out where and when symptoms
occur. As food travels, it can cause stomach pain at different times, depending
where your ulcer is.
location of your symptoms can help determine if the ulcer is gastric or
duodenal, sometimes the pain is called referred. This means a person may have
pain away from where the actual ulcer area is.
But nearly 75 percent
of the people who have gastric or duodenal ulcers don’t have symptoms,
according to Mayo Clinic. In fact, these
ulcers rarely cause severe symptoms.
- blood in the stool or stool that appears dark and/or tarry
- difficulty breathing
- feeling faint or losing consciousness
- vomiting blood
medical attention if you feel stomach pain and any of the symptoms above.
What causes ulcers?
Helicobacter pylori bacteria (H. pylori)
is the most common cause of gastric and duodenal ulcers. This bacterium damages
the mucus that protects your stomach and small intestine, allowing for stomach
acid to burn through. An estimated 30 to 40 percent of Americans get H. pylori, according to the National Institute of Diabetes and Digestive and
Kidney Diseases (NIDDK).
It’s unclear how this bacterium
spreads, but researchers believe it’s mostly through unclean food, water, and
eating utensils. People who carry H.
pylori can also spread it through direct contact.
Many people get this virus as a
child, but it rarely develops into a peptic ulcer. In fact, most people don’t
see symptoms until they’re older, if at all.
People who use or rely on
nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin, ibuprofen, and
naproxen sodium, are more likely to develop peptic ulcers. NSAIDs can irritate
and damage your lining. Acetaminophen, or Tylenol, isn’t included on this list.
A rare condition known as
Zollinger-Ellison syndrome can cause gastric and duodenal ulcers. This
condition causes cancerous and noncancerous tumors to develop in the stomach
Who’s more likely to develop ulcers?
often recommend NSAIDs for health conditions such as arthritis or joint
inflammation, NSAIDs can increase your risk for developing peptic ulcers.
factors known to increase your risk for developing gastric and duodenal ulcers
- being 70 years old or older
- drinking alcohol
- history of peptic ulcers
- untreated stress
don’t increase your risk for ulcers but they can irritate your stomach further. Additional medications
that may increase your risk for gastric and duodenal ulcers include:
How will your doctor diagnose ulcers?
Your doctor will start by asking
about your medical history and symptoms. Let your doctor know when you start
feeling the symptoms and where. Gastric and duodenal ulcers will cause pain in
different parts of your abdomen. If your doctor suspects you may have an ulcer,
they will usually confirm with several tests.
If a doctor thinks H. pylori may have caused the infection,
the following tests can confirm or rule out this possibility:
- Blood test: The presence of certain infection-fighting cells could
mean you have an H. pylori infection.
- Stool culture: A stool sample is sent for lab testing. H. pylori bacteria will grow over the
course of a few days, if present.
- Urea breath test: A urea breath test involves swallowing a pill that
contains carbon and breathing into a bag that’s sent to a lab. High levels of
carbon dioxide can indicate presence of H.
An EGD test involves inserting a
special tool known as a scope that has a lighted camera on its end through your
mouth. The camera takes pictures as it moves down your stomach into the
beginning of your small intestine. Your doctor will use these pictures to look
for ulcers or other abnormal areas.
Your doctor may also order a test
called a barium swallow or an upper GI series. This test involves drinking a
solution with a small amount of radioactive matter. Your doctor will then take
several X-rays to see how the solution moves through your digestive system.
This allows the doctor to examine the X-ray for any potential abnormalities in
How are ulcers treated?
gastric and duodenal ulcers depends upon the causes and how severe your
symptoms are. For example, your doctor may prescribe histamine receptor
blockers (H2 blockers) or proton pump inhibitors (PPIs) to reduce the amount of
acid and protect your stomach lining.
For H. pylori infections,
your doctor will prescribe antibiotics
and other medications to fight the bacteria and promote healing. These
medications include mucosal protective agents, which help protect your
stomach’s mucus lining.
caused the peptic ulcer, a doctor will advise you on how to reduce your use.
If the ulcer is
actively bleeding, your doctor can use special tools to stop the bleeding through
an endoscope during the EGD procedure.
In cases that
medication or endoscopic therapy does not work, your doctor may recommend
If the ulcer
becomes deep enough to cause a hole in the wall of your stomach or duodenum, it
becomes a medical emergency and surgery is most often required to fix the
What’s the outlook for ulcers?
An untreated gastric or duodenal ulcer can develop into a
serious problem, especially if you have existing symptoms.
The most common complications of ulcers are:
It’s important to get treated if you have symptoms related to
gastric or duodenal ulcers.
In some cases, gastric ulcers can increase your risk for
cancerous and noncancerous tumor growth. Duodenal ulcers aren’t usually
associated with cancer.
Your doctor will recommend repeating an EGD after several weeks
of treatment to confirm that the ulcers are healing. But most gastric and
duodenal ulcers will go away with time and treatment.
Can ulcers be prevented?
You can reduce your risk for ulcers by lowering your intake of NSAIDs
or switching to another medication, if you’re taking NSAIDs.
Other methods for prevention include:
- Take NSAIDs with meals or medications that protect your stomach
lining, if you need NSAIDs.
- Avoid or limit caffeinated drinks and alcohol. They may worsen your
- Refrain from smoking, as it can slow healing.
- Take all of your antibiotics, if prescribed, for H. pylori infections. Not taking the entire amount can bring the
- Take steps to reduce the stress in
your life. From sleeping more to taking time to do something you enjoy
(reading, exercising, or writing in a journal), reducing stress can keep gastric
and duodenal ulcer symptoms from getting worse.