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Gastric vs Duodenal Ulcer: What are the key differences?

Medically reviewed by Mia Dacumos, MD · Nephrology · Makati Medical Center

Written by Den Alibudbud · Updated Dec 14, 2020

    Gastric vs Duodenal Ulcer: What are the key differences?

    Gastric vs duodenal ulcer, what’s the difference? In this article, we’ll go through the key differences and similarities between gastric vs duodenal ulcers based on their causes, symptoms, further complications, and warning signs. 

    What are peptic ulcers? 

    Peptic ulcers are sores on the inner lining of certain parts of the digestive system. These are caused by different substances interacting with gastric acids used to break down food and other digestive juices. These then cause burning and irritation, forming  ulcers along the inner lining of either your stomach or the early part of the small intestines.

    Peptic Ulcer Disease – Everything You Need to Know

    Types of ulcers

    There are two types of peptic ulcers and these two types are differentiated based on the location.

    • Gastric ulcers are found on the stomach lining
    • Duodenal ulcers are found in the first section of the small intestines, known as the duodenum

    Peptic ulcer causes vary from patient to patient due to the type of peptic ulcers that occur. One patient can even have both types of ulcers at the same time.


    Both gastric and duodenal ulcers have the same fundamental cause and, as we had mentioned above, that’s the irritation of the lining due to the interaction between substances that are naturally present in the digestive system and foreign substances.

    These foreign substances could be bacteria like Helicobacter pylori or medication like Ibuprofen, Diclofenac, Aspirin, and Naproxen, which fall under a category called non-steroidal anti-inflammatory drugs (NSAIDs).

    Although the causes are similar, it is more likely for duodenal ulcer to be caused by H. pylori rather than NSAIDs, because this medication causes ulcers by breaking down the natural defense of the stomach lining against naturally present gastric acids. This doesn’t happen as often for the duodenal lining because it’s less exposed to gastric acids than the stomach since the stomach is where these gastric acids are primarily used and produced.

    Gastric vs Duodenal Ulcer Symptoms

    Common peptic ulcer symptoms are

    • Burping and belching
    • Early satiety
    • Not feeling hungry
    • Having bloody or black stool
    • Vomiting blood

    These vary from case to case since it’s definitely possible to not have any symptoms at all.

    These signs and symptoms are of the same kind for both gastric and duodenal ulcers, but the nuances are differentiatd with the likelihood of these symptoms occurring.

    Peptic ulcers could also cause pain. And although it may be tempting to assume that the location of this pain is the ulcer, it’s not necessarily the case. The timing and triggers, however, of these sensations could be indicative of whether it is a gastric ulcer or a duodenal ulcer. 

    Symptoms caused by gastric ulcers

    • Occurring in the stomach, are more likely to cause the symptoms involving appetite like someone immediately feeling full right after eating or not getting hungry.
    • The lack of food would be a likely pain trigger for gastric ulcers
    • As for the timing, the pain could happen right after eating, which is likely for gastric ulcers

    Symptoms caused by duodenal ulcers

    • More likely to cause symptoms involving stool like its color being black or blood being present.
    • The ntake of food would be a likely pain trigger for duodenal ulcers. 
    • As for the timing, the pain could happen a few hours later, which is likely for duodenal ulcers.

    Antacids and food intake could also help provide some kind of relief from pain caused by duodenal ulcers but it would not be as effective for pain caused by gastric ulcers.

    Possible complications of gastric vs duodenal ulcer

    Similar to the causes and symptoms, the possible complications that could arise from peptic ulcers are quite similar for both gastric and duodenal ulcers. These complications include internal bleeding, perforation or tearing of the organ lining, and obstruction.

    The internal bleeding could occur in both the stomach and duodenum. If it is taken to the extreme, this could cause anemia down the line. 

    The perforation or tearing occurs in the organ that is affected by the ulcers. In this case, the lining of the stomach could tear due to gastric ulcers, while the lining of the small intestine could tear due to duodenal ulcers.

    Obstruction is more likely to occur for gastric ulcers since its outlet is more likely to be irritated enough to cause blockages. A linked disease would be the Zollinger-Ellison syndrome that causes gastric ulcers due to high levels of stomach acid.

    When to see a doctor

    Make sure to see a doctor if symptoms such as

    • Extreme weakness
    • Vomiting
    • Excreting blood
    • Sudden weight loss
    • Severe pain spreading to the lower back
    • Constant or worsening nausea

    The doctor could use endoscopy, barium swallow, or laboratory tests like testing for the presence of H. pylori. These can help determine whether or not this pain is caused by peptic ulcers and what treatment plan works best.

    Key Takeaways

    Although gastric and duodenal ulcers are similar to great extents, there are the few nuances and differences between them. 

    The easiest way of telling which kind of peptic ulcer is present is based on the location of the ulcers. However, this can only be determined by lab tests and check-ups after the diagnosis.

    In the end, diagnosis and classification should be left to the medical experts. They are best to recommend treatment plans to get rid of either or both conditions for good.

    Learn more about Digestive Health here. 


    Hello Health Group does not provide medical advice, diagnosis or treatment.

    Medically reviewed by

    Mia Dacumos, MD

    Nephrology · Makati Medical Center

    Written by Den Alibudbud · Updated Dec 14, 2020

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