Can ulcers affect your legs? Differentiating causes of leg pain and sores

September 24, 2025 •

4 min read

Affecting between 500,000 and 2 million Americans each year, leg ulcers are a common but distinct medical issue from digestive ulcers. The question, Can ulcers affect your legs?, highlights a common confusion between abdominal pain and symptoms appearing in the lower extremities.

Quick Summary

Leg ulcers are typically the result of circulatory problems like venous insufficiency or diabetes, not stomach ulcers. While a stomach ulcer can cause referred pain, symptoms in the legs from gastrointestinal issues are more often linked to systemic inflammation from conditions like inflammatory bowel disease (IBD).

Key Points

Leg ulcers and stomach ulcers are distinct conditions: Leg ulcers are open sores on the legs caused by circulatory issues or diabetes, whereas stomach ulcers are internal sores caused by bacteria or NSAIDs.
Referred pain can be misleading: In rare instances, severe abdominal pain from a peptic ulcer can be felt in the legs, but this does not cause a physical leg ulcer.
Inflammatory Bowel Disease (IBD) is a link: Chronic inflammation from conditions like Crohn's disease can cause skin lesions (erythema nodosum) and joint pain in the legs.
Dehydration and electrolyte imbalance are indirect causes: Severe vomiting or diarrhea from GI issues can lead to dehydration, resulting in leg muscle cramps and aches.
Always consult a doctor for a proper diagnosis: Never self-diagnose based on symptoms. A persistent leg sore or unusual pain needs professional medical evaluation to identify the correct underlying cause.

The Distinction: Peptic Ulcers vs. Leg Ulcers

The word "ulcer" simply refers to an open sore, but its location is critical for diagnosis and treatment. Most people think of peptic ulcers when they hear the term, but this is a very different condition from the wounds that can appear on the legs.

Peptic Ulcers

Peptic ulcers are open sores that develop on the inside lining of the stomach (gastric ulcers) or the upper part of the small intestine (duodenal ulcers). They are typically caused by Helicobacter pylori bacteria or long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs). The primary symptom is abdominal pain, often described as a burning sensation. This pain can be severe and may be felt elsewhere, but it does not cause leg wounds or vascular problems.

Leg Ulcers

Leg ulcers are open, non-healing wounds that typically develop on the lower legs, often near the ankles. The most common causes are related to poor blood circulation and other underlying health conditions, not the digestive tract.

Venous Leg Ulcers: This is the most common type, caused by high pressure in the veins of the lower leg (venous insufficiency). Faulty valves allow blood to pool, leading to swelling and skin breakdown.
Arterial Leg Ulcers: These occur due to poor blood flow in the arteries (peripheral artery disease), causing tissue death.
Diabetic/Neuropathic Ulcers: People with uncontrolled diabetes can develop nerve damage (neuropathy) and circulation issues, leading to ulcers, especially on the feet.

Indirect Connections: When Gut Issues Affect Your Legs

While a direct causal link is rare, some digestive or systemic conditions can cause symptoms that manifest in the legs, leading to a mistaken connection with ulcers.

Visceral Referred Pain

Visceral referred pain is pain that originates in an internal organ but is felt in a different location on the body. It is possible for severe peptic ulcer pain to radiate, and in rare cases, this pain can be perceived in the legs. However, this is not a leg ulcer but rather a nervous system phenomenon and is not common.

Inflammatory Bowel Disease (IBD)

Inflammatory bowel disease, which includes Crohn's disease and ulcerative colitis, is a chronic inflammatory condition of the digestive tract. For some individuals, this inflammation can extend beyond the gut and cause extra-intestinal manifestations in other parts of the body, including the legs.

Common IBD-related leg symptoms include:

Erythema Nodosum: Painful, red lumps that typically appear on the shins during an IBD flare-up.
Pyoderma Gangrenosum: A more severe, painful ulcer-like sore that starts as a small bump and rapidly grows.
Arthralgia (Joint Pain): Inflammation can affect large joints like the knees, hips, and ankles.

Nutrient Absorption Issues and Dehydration

Chronic gastrointestinal problems can lead to poor nutrient absorption and, in cases of severe vomiting or diarrhea, dehydration.

Electrolyte Imbalance: Dehydration can cause an imbalance of electrolytes, which are essential for proper muscle function, leading to muscle aches and leg cramps.
General Fatigue: Malnutrition and chronic illness can cause overall weakness and fatigue, which may contribute to a sensation of heaviness or pain in the legs.

Comparison of Different Ulcer Types


Feature	Peptic Ulcer	Venous Leg Ulcer	Arterial Leg Ulcer	Diabetic Neuropathic Ulcer
Location	Stomach or small intestine lining	Inner leg, usually near the ankle	Toes, foot, or shin	Pressure points on the foot (soles, heel)
Cause	H. pylori, NSAIDs	Poor circulation (venous insufficiency)	Poor circulation (peripheral artery disease)	Nerve damage (neuropathy), diabetes
Appearance	Internal sore (not visible)	Shallow, red base, uneven borders, may weep fluid	Deep, dry, "punched out" look, poor granulation	Deep wound, often painless, surrounded by a callus
Pain	Abdominal burning, may radiate	Aching, heavy feeling in the legs	Severe, often worse with elevation	Can be painless due to nerve damage
Associated Symptoms	Nausea, indigestion	Swelling, skin discoloration, itching	Cold extremities, weak pulses, pain at rest	Numbness, tingling, loss of sensation

When to See a Doctor

Distinguishing between internal issues and leg-specific problems is crucial for appropriate treatment. If you experience persistent or worrying symptoms, a medical evaluation is necessary. While a stomach ulcer won't directly cause a leg sore, a different underlying condition could be responsible.

Leg symptoms accompanied by GI distress: Pain or skin lesions on your legs along with chronic abdominal pain, diarrhea, or other persistent digestive issues warrant a visit to a gastroenterologist or a general practitioner.
Non-healing leg sores: Any sore on your leg that doesn't heal within a couple of weeks should be evaluated by a healthcare provider, especially if you have risk factors like diabetes or vascular disease. Early treatment is essential to prevent infection and other complications.

Conclusion

To answer the question, can ulcers affect your legs?, the answer is not in the way many people assume. A peptic ulcer in the stomach will not cause a sore on your leg. Rather, chronic leg sores are a separate medical issue primarily related to circulatory problems or diabetes.

It is important to understand the distinctions between these conditions. Symptoms like leg pain, swelling, and skin changes can, however, be extra-intestinal manifestations of systemic inflammatory conditions like IBD, or a result of dehydration from severe gut issues. Always seek professional medical advice for persistent symptoms to ensure an accurate diagnosis and proper treatment plan.

For more information on digestive diseases, consider visiting the National Institutes of Health (NIH) website.

Frequently Asked Questions

No, a stomach ulcer itself does not directly cause leg swelling. Leg swelling, or edema, is a common symptom of venous leg ulcers and other circulatory problems, not peptic ulcers. If you have both abdominal symptoms and leg swelling, it may indicate two separate issues or a systemic condition like IBD.

The most common cause of leg ulcers is poor blood circulation in the leg veins, a condition known as venous insufficiency. This leads to increased pressure, fluid buildup, and skin damage that results in an open sore.

Severe, bleeding stomach ulcers can cause referred pain, which might include sensations in the back or legs, but this is rare. More common symptoms of a bleeding ulcer include black, tarry stools, vomiting blood, and feeling dizzy or fainting.

Diabetic ulcers, or neuropathic ulcers, typically form on the soles of the feet, particularly over bony pressure points. They are often painless due to nerve damage, which is a key distinguishing feature from painful vascular ulcers.

Referred pain is when pain from an internal organ is felt in a different area of the body. For an abdominal ulcer, pain might be felt in the neck, shoulder, or back. While less common, it could be perceived in the legs, but this is a sensory phenomenon, not a cause of leg sores.

Yes, inflammatory bowel disease (IBD) can cause several types of skin problems, including erythema nodosum (tender, red lumps on the shins) and pyoderma gangrenosum (severe ulcer-like sores), as extra-intestinal manifestations of the disease.

If you have a wound on your leg that is not healing after two weeks, it is crucial to see a healthcare provider. Chronic wounds can lead to serious infections if left untreated. Your doctor can determine the cause and recommend a treatment plan.