More than four million people in the United States suffer from the unpleasant symptoms of peptic ulcers each year. In fact, approximately 10 percent of the U.S. population is coping with a peptic ulcer at any given time. Peptic ulcers, which are open sores, fall into two main categories: gastric ulcers and duodenal ulcers— gastric ulcers occur in the stomach, and duodenal ulcers occur in the upper gastrointestinal tract. Although both types share several symptoms, there are distinct differences between the two.
Although duodenal and gastric ulcers are distinctly different, they also share several key characteristics. The stomach and the duodenum are both covered by layers of mucous membranes. When they function properly, those membranes protect the stomach and the duodenum from the digestive juices and enzymes that break down foods and beverages. Duodenal and gastric ulcers are most commonly caused by a bacteria called Helicobacter pylori, or H. pylori. H. pylori is usually present and doesn't cause any trouble. Occasionally, though, it causes a disruption in the mucous membranes of the duodenum and/or stomach that prompts inflammation and, ultimately, ulcers.
The duodenum refers to the upper region of the small intestine. Duodenal ulcers cause an aching, burning, hunger-like pain in the upper-middle portion of the abdomen, just below the breastbone. This pain tends to develop or worsen when the stomach is relatively empty—usually two to five hours after eating. Another telltale sign of a duodenal ulcer is pain that occurs during the middle of the night, when acid secretion and production is the most rampant.
Ulcers that occur in the stomach are called gastric ulcers. The pain from these ulcers tends to occur immediately after eating. Gastric ulcer pain doesn't tend to respond very well to antacids and other over-the-counter medications; eating doesn't make the pain subside, but tends to exacerbate it. In other words, pain happens when the stomach is full—unlike duodenal ulcer pain, which occurs when the stomach is empty.