What are the 7 types of ulcers and their symptoms?

According to research, up to 25% of people with diabetes will develop a diabetic foot ulcer in their lifetime. Understanding the different ulcer types is vital for proper diagnosis and care, and this guide explores what are the 7 types of ulcers most commonly encountered and where they occur on the body.

Quick Summary

The seven common types of ulcers include peptic, esophageal, arterial, diabetic foot, venous, genital, and mouth ulcers, each presenting with unique symptoms depending on their location.

Key Points

• Seven main types: The most common types of ulcers are peptic, esophageal, arterial, diabetic foot, venous, genital, and mouth ulcers.

• Location is key: The location of the ulcer is the primary way to differentiate between types, from the digestive tract to the skin and mucous membranes.

• Diverse causes: Ulcers can be caused by bacterial infections (H. pylori), persistent acid reflux (GERD), poor blood circulation, nerve damage, or even trauma.

• Varying symptoms: Symptoms differ greatly by type, including burning stomach pain for peptic ulcers, painful swallowing for esophageal ulcers, and numbness for diabetic foot ulcers.

• Seek professional diagnosis: Due to the wide range of potential causes and severity, a healthcare professional should always diagnose and treat ulcers, especially if they are chronic or severe.

Peptic Ulcers

Peptic ulcers are open sores that develop on the lining of the stomach (gastric ulcers) or the first part of the small intestine (duodenal ulcers). They form when the protective mucus layer of the gastrointestinal tract is worn away, making the tissue susceptible to damage from stomach acid.

Causes of Peptic Ulcers

• Helicobacter pylori (H. pylori) infection: This common bacterium can cause inflammation and damage to the stomach and duodenal linings.
• Long-term use of NSAIDs: Frequent or prolonged use of nonsteroidal anti-inflammatory drugs like aspirin and ibuprofen can increase vulnerability to stomach acid.
• Excessive stomach acid: Overproduction of stomach acid can contribute to ulcer formation.

Symptoms of Peptic Ulcers

Symptoms can range from mild to severe and may include:

• Burning stomach pain, often between meals or at night
• Bloating or a feeling of fullness
• Heartburn
• Nausea and vomiting
• Dark, tarry stools (indicating bleeding)

Esophageal Ulcers

Esophageal ulcers are sores that form in the lining of the esophagus, the muscular tube connecting the throat to the stomach. They are most often caused by persistent acid reflux.

Causes of Esophageal Ulcers

• Gastroesophageal reflux disease (GERD): Chronic acid reflux wears away the esophageal lining.
• Infections: Certain infections, such as those caused by the herpes simplex virus or Candida yeast, can lead to ulcers.
• Medications: Some oral medications, if not swallowed with enough water, can irritate and damage the esophagus.

Symptoms of Esophageal Ulcers

• Heartburn and chest pain
• Difficulty or pain when swallowing
• Nausea and vomiting
• A sensation of food being stuck in the throat

Arterial Ulcers

Also known as ischemic ulcers, these skin sores result from poor blood circulation due to blocked arteries. They typically appear on the feet, ankles, or toes and are often extremely painful.

Causes of Arterial Ulcers

• Atherosclerosis: Plaque buildup narrows and hardens the arteries, restricting blood flow.
• Peripheral vascular disease: A condition that causes narrowed blood vessels in the legs and feet.
• High blood pressure and diabetes: These conditions can contribute to vascular damage.

Symptoms of Arterial Ulcers

• Well-defined, rounded wounds with a “punched-out” appearance
• Extremely painful, especially when the legs are elevated
• Cool, shiny skin with hair loss on the affected leg or foot
• Minimal bleeding or discharge

Diabetic Foot Ulcers

These are open sores that commonly develop on the bottom of the feet in people with diabetes, affecting 15–25% of the diabetic population. They are caused by a combination of nerve damage (neuropathy) and poor circulation.

Causes of Diabetic Foot Ulcers

• Neuropathy: Nerve damage leads to numbness, preventing a person from feeling foot injuries.
• Peripheral vascular disease: Restricted blood flow impairs the body's ability to heal wounds.
• Foot deformities and poor footwear: These can cause chronic pressure and irritation.

Symptoms of Diabetic Foot Ulcers

• Drainage from the wound, sometimes with an odor
• Discolored tissue (black or brown)
• Swelling and calluses around the wound
• The wound itself may not be painful due to nerve damage

Venous Ulcers

Venous ulcers are the most common type of chronic leg ulcer, caused by improper blood return to the heart from the leg veins. This causes increased pressure in the veins, leading to a breakdown of the skin.

Causes of Venous Ulcers

• Chronic venous insufficiency: Damaged valves in leg veins fail to pump blood effectively.
• Venous hypertension: High pressure within the veins, often due to blood clots (DVT) or obesity.
• Previous leg trauma or injury: Can damage the venous system.

Symptoms of Venous Ulcers

• Irregular, shallow open wounds, often on the inner ankle or lower leg
• Surrounding skin may be discolored (brownish) and itchy
• Pain, swelling, and varicose veins may be present

Genital Ulcers

These sores appear on or around the genitals and are most frequently caused by sexually transmitted infections (STIs). They can appear as single lesions or a cluster of sores.

Causes of Genital Ulcers

• Herpes simplex virus (HSV): Causes painful, fluid-filled blisters that can become ulcers.
• Syphilis: Can cause a single, painless chancre sore.
• Chancroid: A rare STI causing painful genital sores.
• Behçet’s syndrome: A rare inflammatory condition that can cause genital ulcers.

Symptoms of Genital Ulcers

• Single or multiple sores on the genitals, anus, or surrounding skin
• Pain, itching, or sometimes painless
• Swollen lymph nodes and a general feeling of being unwell

Mouth Ulcers

Also known as canker sores or aphthous ulcers, these small, painful sores form inside the mouth, on the tongue, or on the inside of the cheeks or lips. Most heal on their own within a couple of weeks.

Causes of Mouth Ulcers

• Minor trauma: Biting the cheek, ill-fitting dental appliances, or cuts from food.
• Nutritional deficiencies: Lack of iron, vitamin B12, or folate can contribute.
• Food sensitivities or allergies: Certain foods can trigger them.
• Stress: A weakened immune system due to stress can be a factor.

Symptoms of Mouth Ulcers

• Painful, round sores, typically white or yellow with a red border
• Swelling around the ulcer
• Pain when eating, drinking, or talking

Comparison of Common Ulcer Types

Ulcer Type	Location	Common Cause	Key Symptom
Peptic	Stomach/Duodenum	H. pylori infection, NSAIDs	Burning stomach pain
Esophageal	Esophagus	GERD	Painful swallowing, heartburn
Arterial	Lower legs/feet	Poor circulation	Intense pain, especially at night
Diabetic Foot	Bottom of feet	Neuropathy, poor circulation	Numb wound, drainage
Venous	Lower legs/ankles	Venous insufficiency	Shallow, irregular wounds
Genital	Genital area	STIs	Sores, itching, pain
Mouth	Inside mouth/lips	Trauma, stress	Small, painful sores

Conclusion: Understanding the Right Diagnosis

Recognizing the distinction between different types of ulcers is essential for seeking appropriate medical attention and treatment. What might be a minor irritant in the mouth could indicate a severe systemic issue elsewhere. If you suspect you have an ulcer, especially if it is chronic, painful, or accompanied by other serious symptoms like unexplained bleeding or numbness, it is crucial to consult a healthcare professional. A proper diagnosis from a medical expert is the first step toward effective management and healing. For more information on managing digestive health, you can visit the American College of Gastroenterology.

Frequently Asked Questions

What is the most common type of ulcer?

The most common internal ulcers are peptic ulcers, which form in the stomach or small intestine. Among leg ulcers, venous ulcers are the most prevalent, often resulting from poor circulation.

Can stress or spicy food cause ulcers?

Contrary to popular belief, stress and spicy foods do not directly cause ulcers. However, they can worsen existing ulcers by increasing stomach acid production or irritating the area.

How are peptic ulcers diagnosed?

Peptic ulcers are typically diagnosed through an upper endoscopy (EGD), where a doctor uses a small camera to examine the stomach lining and small intestine.

Are mouth ulcers the same as canker sores?

Yes, mouth ulcers are often referred to as canker sores. They are small, painful sores that develop inside the mouth and usually heal on their own.

What is the primary cause of venous ulcers?

Venous ulcers are primarily caused by chronic venous insufficiency, a condition where leg veins fail to return blood to the heart effectively, leading to high pressure and skin breakdown.

Who is at risk for diabetic foot ulcers?

Anyone with poorly controlled diabetes is at risk for diabetic foot ulcers, especially those with nerve damage (neuropathy) or poor circulation in their lower extremities.

When should I see a doctor about an ulcer?

You should consult a doctor if an ulcer is persistent, extremely painful, doesn't heal, or is accompanied by other severe symptoms like bleeding, black stool, or chest pain.

Can arterial ulcers heal on their own?

Because they are caused by restricted blood flow, arterial ulcers often have difficulty healing without medical intervention to address the underlying circulatory issues. Healing can take months to years.