Where Are Ulcers Typically Located? A Comprehensive Guide

September 29, 2025 •

4 min read

Millions of people suffer from peptic ulcers annually, but many are unaware of their exact location. Understanding where are ulcers typically located is the first step toward understanding the condition and seeking proper medical care. The most common locations are in the stomach and the small intestine.

Quick Summary

Ulcers most frequently form in the lining of the stomach (known as gastric ulcers) and the upper part of the small intestine (referred to as duodenal ulcers). This occurs when the protective mucosal lining is eroded by digestive acids, leading to open sores.

Key Points

Primary Locations: Ulcers most commonly develop in the stomach (gastric ulcers) and the duodenum (duodenal ulcers).
Main Causes: The two main causes are infection with the H. pylori bacterium and the long-term use of NSAID medications.
Pain Patterns Differ: Gastric ulcer pain often gets worse with eating, while duodenal ulcer pain often improves with it.
Diagnosis is Key: Diagnosis typically involves specific tests for H. pylori and an upper endoscopy to confirm the location and cause.
Treatment Depends on Cause: Treatment protocols differ based on whether the ulcer is caused by H. pylori or NSAID usage.
Seek Medical Advice: Always consult a healthcare professional for persistent symptoms to ensure an accurate diagnosis.

Understanding Peptic Ulcer Disease

Peptic ulcer disease (PUD) is a condition in which painful sores, or ulcers, develop in the lining of the stomach or the first part of the small intestine. While historically believed to be caused by stress or spicy foods, research has shown that the vast majority are caused by a specific bacterial infection or the long-term use of certain medications.

The Two Primary Locations of Ulcers

The name 'peptic ulcer' refers to any ulcer that forms in the part of the body that comes into contact with stomach acid and the digestive enzyme, pepsin. Therefore, the two most common locations are the stomach and the duodenum.

Gastric Ulcers: The Stomach Lining

Gastric ulcers are sores that develop on the lining of the stomach. The stomach’s lining has a robust mucous layer that typically protects it from the acidic environment. However, when this protective barrier is compromised, the stomach acid can erode the tissue, causing an ulcer. Gastric ulcers can be more complex to manage than their duodenal counterparts, as they carry a slightly higher risk of malignancy, though this is rare.

Duodenal Ulcers: The Small Intestine

Duodenal ulcers form in the duodenum, which is the first section of the small intestine, immediately following the stomach. These are the most common type of peptic ulcer. The duodenum receives the acidic contents of the stomach, and a breakdown of its mucosal lining can lead to these sores. Unlike gastric ulcers, the pain from a duodenal ulcer often improves temporarily after eating, as food can buffer the acid.

Key Differences Between Gastric and Duodenal Ulcers

While both are types of peptic ulcers, there are notable differences in their typical presentation and management. Here is a comparison:


Feature	Gastric Ulcer	Duodenal Ulcer
Location	Inside the stomach lining	In the first part of the small intestine (duodenum)
Pain Pattern	Often worsens with eating or shortly after	Often relieved by eating; returns 2-3 hours later
Prevalence	Less common than duodenal ulcers	More common than gastric ulcers
Common Symptoms	Nausea, vomiting, weight loss	Night pain, heartburn, bloating, weight gain (from eating to relieve pain)
Cancer Risk	Slightly higher (though still low)	Minimal to no risk of malignancy

Less Common Locations for Ulcers

While the stomach and duodenum are the most frequent sites, ulcers can also form elsewhere in the digestive tract. An esophageal ulcer, for instance, is a sore in the lining of the esophagus (the tube connecting the throat and stomach). This can result from chronic acid reflux disease (GERD). In very rare cases, ulcers can develop in the jejunum or ileum, which are further down the small intestine.

What Causes Ulcers?

Understanding the causes is critical for prevention and effective treatment. The two main culprits are bacterial infection and medication use.

Helicobacter pylori (H. pylori): This is a type of bacterium that can live in the digestive tract and cause chronic inflammation. It is responsible for the majority of peptic ulcers. Many people carry the bacterium without symptoms, but for some, it leads to a breakdown of the protective lining.
NSAIDs (Nonsteroidal Anti-Inflammatory Drugs): Long-term and frequent use of medications like aspirin, ibuprofen, and naproxen can cause ulcers. NSAIDs inhibit the body's production of a substance called prostaglandins, which protect the stomach lining from stomach acid. Without this protection, ulcers can form.

Diagnosis and Treatment Options

Diagnosing where an ulcer is typically located involves a combination of medical history, physical examination, and specific tests. Your doctor might recommend:

H. pylori Tests: This can involve a breath test, a stool test, or a blood test.
Upper Endoscopy: A flexible tube with a camera is inserted through the mouth to view the stomach and duodenum. This is the most definitive way to confirm an ulcer's location and appearance.
Barium Swallow: An X-ray is taken after you drink a special liquid that coats the digestive tract.

Once diagnosed, treatment depends on the cause. For H. pylori infection, antibiotics are prescribed. For NSAID-related ulcers, discontinuing the medication (if possible) is key, along with medications that block acid production or protect the stomach lining.

For more detailed information, consult a medical professional or a reputable resource such as the American College of Gastroenterology.

Conclusion

In conclusion, if you are wondering where are ulcers typically located, the answer points mainly to the stomach (gastric) and the duodenum (small intestine). While sharing similar symptoms, they differ in location, pain patterns, and overall prevalence. Knowing the primary causes, H. pylori and NSAID use, is vital for proper diagnosis and treatment. Seeking medical attention for persistent symptoms is always the safest course of action to ensure accurate diagnosis and effective management of the condition.

Frequently Asked Questions

The most common location for a peptic ulcer is the duodenum, which is the first part of the small intestine, immediately following the stomach.

Yes, although less common, ulcers can also form in the esophagus (esophageal ulcers) due to chronic acid reflux disease (GERD). In rare cases, they can be found further down the small intestine.

A gastric ulcer is in the stomach, while a duodenal ulcer is in the small intestine. A key distinction is that pain from duodenal ulcers often temporarily subsides with food, while gastric ulcer pain may be worsened by eating.

No, stress and spicy food do not cause ulcers. However, they can potentially aggravate existing ulcer symptoms by increasing stomach acid production or causing discomfort.

Doctors typically use an upper endoscopy to visualize the lining of the stomach and duodenum directly. This allows them to see and confirm the exact location of any ulcers.

The early signs of ulcers in either location are often similar, including burning stomach pain, bloating, and indigestion. The difference in pain timing relative to eating can offer a clue about the location.

Yes, it is possible to have multiple peptic ulcers at the same time. The presence of H. pylori or prolonged NSAID use can affect multiple areas of the digestive tract.