A Guide to 7 Common Types of Ulcers

Medically Reviewed By Megan Soliman, MD

There are seven common types of ulcers: peptic, esophageal, arterial, diabetic foot, venous, genital, and mouth. Depending on the location of the ulcer, symptoms can include pain, nausea, heartburn, or itching. Treatment can include antibiotics, acid reducers, antiviral drugs, surgery, or lifestyle changes. Ulcers are open sores that can occur on internal and external parts of the body. They can be mild or serious.

Read on to learn more about the different types of ulcers, what causes them, and how doctors treat them.

1. Peptic ulcers

There are two main types of peptic ulcers.

  • Gastric ulcers develop in the stomach.
  • Duodenal ulcers develop in the upper part of the small intestine, which is called the duodenum.

Causes

There are two main causes of peptic ulcers.

  • Bacterial infection: Infection with the bacterium Helicobacter pylori (H. pylori) can cause Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source inflammation and damage to your stomach and duodenum linings, resulting in ulcers.
  • Nonsteroidal anti-inflammatory drugs (NSAIDs): NSAIDs, including aspirin and ibuprofen, are typically used to treat pain. Frequent use of NSAIDs can cause ulcers because these drugs make your stomach and duodenum more vulnerable to stomach acid. 

Contrary to popular belief, stress and spicy foods do not cause ulcers. However, certain foods may worsen an ulcer that is already present.

Symptoms

Some common symptoms of peptic ulcers include:

Peptic ulcers can bleed, which can be serious or even life threatening. If an ulcer is bleeding slowly, you may not notice any symptoms until you become anemic.

Anemia occurs when your blood does not have enough red blood cells to carry oxygen to the rest of your body. Symptoms of anemia include:

If an ulcer is bleeding rapidly, symptoms can include:

If you are experiencing symptoms that could indicate a rapidly bleeding ulcer, call 911 or go to the nearest emergency room.

Diagnosis

One of the most common ways for doctors to diagnose peptic ulcers is with esophagogastroduodenoscopy (EGD), or an upper endoscopy.

Doctors insert a small, flexible tube with a camera through your mouth and into your stomach and the upper part of the small bowel. If they find signs of an ulcer, they can take pictures of it, take a small sample for analysis, and even treat it if there is bleeding.

Treatment

Some common treatments for peptic ulcers include:

  • Proton pump inhibitors (PPIs): PPIs block acid production in your stomach, allowing the ulcers to heal.
  • Antibiotics: If H. pylori caused your ulcer, antibiotics would be necessary to get rid of the infection.
  • NSAID cessation: If NSAID overuse caused your ulcer, talk with your doctor about alternative pain medications.

If the ulcer is bleeding, a doctor may treat it during your EGD. They can inject medications into the site, put a small clip on a bleeding vessel, or close a bleeding vessel by burning it.

Outlook

The outlook for peptic ulcers is generally good. You may have to take PPIs for several weeks to allow the ulcer to heal. If your doctor prescribes antibiotics for an H. pylori infection, it is important to complete the full course to keep the infection from coming back.

2. Esophageal ulcers

Esophageal ulcers form in the esophagus, which is the tube that connects your throat to your stomach. When the inner lining of the esophagus is damaged, an ulcer forms.

Causes

The most common Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source cause of esophageal ulcers is gastroesophageal reflux disease (GERD), or acid reflux. This condition occurs when stomach acid backs up into the esophagus. Stomach acid wears away the lining of the esophagus, causing ulcers.

Other causes of esophageal ulcers include:

  • frequent vomiting
  • the use of medications that irritate the esophagus
  • infections
  • the consumption of liquids rich in acid, such as caffeinated drinks and alcohol
  • smoking

Symptoms

The symptoms of esophageal ulcers include:

Diagnosis

As with peptic ulcers, your doctor may perform an EGD to diagnose esophageal ulcers.

They may also perform a barium-contrast esophagram. During this procedure, you will swallow a liquid containing barium sulfate. This liquid will coat the esophagus so that the lining is clearly visible on an X-ray.

Treatment

Treatment for esophageal ulcers mainly focuses Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source on treating the underlying cause. If you have an ulcer caused by GERD, your doctor will likely prescribe PPIs or H2 blockers. H2 blockers are medications that reduce the amount of acid produced by the stomach, providing temporary relief.

If an infection caused your ulcer, a doctor could prescribe antibiotics or antiviral medications. If a medication irritates your esophagus, you may need to stop taking it.

Making lifestyle changes, such as quitting smoking and drinking fewer acid-rich liquids, may be beneficial in healing and preventing esophageal ulcers.

Outlook

The outlook for esophageal ulcers is good if you follow your doctor’s treatment plan. It is important to complete the full course of your prescribed medications to allow ulcers to heal completely.

It is also helpful to maintain an appropriate diet.

3. Arterial ulcers

Arterial ulcers, also called ischemic ulcers, occur when there is an insufficient blood supply to the lower extremities. They frequently occur on the feet and lower legs. An open wound forms when your skin and tissue do not receive adequate blood supply.

Causes

The causes of arterial ulcers include:

Symptoms

An arterial ulcer near the ankle
Arterial ulcers commonly develop on the lower legs, feet, or toes. nayafana/Shuttertsock

Arterial ulcers typically appear as symmetrical open wounds on your lower legs or feet. They can be brown, black, yellow, or gray. These ulcers typically do not bleed, but they are extremely painful.

Other symptoms of arterial ulcers include:

  • increased pain at night
  • cool, shiny skin surrounding the wound
  • leg hair loss
  • faint pulse in the extremity

Diagnosis

To diagnose an arterial ulcer, a doctor will examine your medical history and symptoms. They may also perform certain tests, including:

  • Buerger test: This test involves analyzing how well blood flows to your extremities. You will lie flat on a bed, raise your leg to a 45-degree angle for 1 minute, and then lower it below the bed. The color of your foot in these positions can indicate insufficient blood flow.
  • Transcutaneous oximetry: This measures the oxygen content of the skin around the wound. If the test shows low oxygen content, it can indicate arterial insufficiency.
  • Ankle-brachial pressure index (ABPI): This is a measurement of the blood pressure in your arm and your ankle.
  • Capillary refill time: This measures how long it takes for the blood vessels in your skin surface to fill with blood after they are pressed.

Treatment

Treatment for arterial ulcers involves addressing the underlying cause. For example, if high blood pressure caused an arterial ulcer, you may need to make some lifestyle and diet changes.

If the wound shows signs of an infection, such as swelling or discharge, your doctor may prescribe oral antibiotics.

In some cases, doctors may use skin grafting to cover the wound. The affected extremity may also need surgical revascularization, which involves either bypassing narrowed vessels or reopening them. This procedure will promote healing by restoring blood flow to the area.

Outlook

The outlook for arterial ulcers varies depending on the underlying cause. Because restricted blood flow causes these ulcers, healing can take months to years. Your doctor will determine the best long-term treatment plan.

4. Diabetic foot ulcers

Diabetic foot ulcers are common among people with uncontrolled diabetes. Researchers estimate that 15–25% Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source of people with diabetes will develop a diabetic foot ulcer. These ulcers typically develop on the bottom of the foot.

Causes

The main causes of diabetic foot ulcers include:

  • inadequate foot care
  • peripheral vascular disease, which is a condition wherein the blood vessels in the lower extremities become narrowed and restrict blood flow
  • neuropathy, which is a condition wherein nerve damage causes pain, weakness, or numbness
  • atypical blood sugar levels

Symptoms

A diabetic ulcer on the bottom of the foot
Diabetic foot ulcers commonly develop on the bottom of the foot. Tridsanu Thopet/Shutterstock

A diabetic foot ulcer will appear as an open wound, commonly on the bottom of your foot. The wound may have the following characteristics:

  • drainage, potentially with an odor
  • tissue discoloration, commonly black or brown
  • calluses
  • swelling
  • blisters
  • pain

Diagnosis

To diagnose a diabetic foot ulcer, your doctor may perform Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source tests such as:

  • swabbing the wound or taking a deep tissue sample to look for signs of infection
  • blood tests to check certain substance levels, including blood sugar levels
  • scans and probes to check for bone involvement

Treatment

To treat diabetic foot ulcers, doctors typically prescribe Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source antibiotics to treat any underlying infections. They may also need to perform surgical revascularization to address restricted blood flow to the area. Your doctor may also remove any calluses and dead or infected tissue.

In extreme cases, removal of bone or amputation of the foot may be necessary.

Outlook

If a diabetic foot ulcer is diagnosed and treated early, the outlook is generally good. However, any delay in treatment can result in serious complications, such as infections, gangrene, and amputation.

5. Venous ulcers

Venous ulcers are open sores that occur on the legs. They are the most common chronic leg ulcers, affecting 1–3% of people in the United States.

Causes

Two conditions that affect your veins typically cause Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source venous ulcers.

  • Chronic venous insufficiency: This means that your leg veins are not returning blood to the heart effectively.
  • Venous hypertension: This means that there is increased pressure in your veins.

These conditions cause excess blood to build up in your leg veins, increasing the pressure and causing an ulcer to form.

Symptoms

A venous ulcer on the leg
Venous ulcers commonly develop on the legs. Jonathan Moore, CC BY 3.0, via Wikimedia Commons

Venous ulcers are typically irregular, shallow open wounds on the legs. They often form over bones, such as the lower leg bone or the ankle. The ulcers can have a brownish color, and they may have discharge.

Other symptoms of venous ulcers include:

Diagnosis

To diagnose venous ulcers, your doctor will examine Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source the wound and the skin around it. They will assess the location of the wound and determine if there are signs of venous insufficiency.

Like with arterial ulcers, a doctor may perform an ABPI test to check your blood pressure. They may also perform a color-flow duplex ultrasound, which will help them analyze your vein structure and blood flow.

Treatment

Treatment for venous ulcers typically falls Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source into two categories.

  • Compression therapy: This involves using hosiery or bandages to apply gentle pressure to the leg, which will promote better blood flow.
  • Wound care: Keeping the wound clean and avoiding infection is essential to promote healing.

In some cases, skin grafting may be necessary. Doctors may also need to perform endovenous ablation, which is a procedure that closes off varicose veins.

Outlook

The outlook for venous ulcers depends on Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source the size of the wound and how long it has been there. Ulcers that are large and have been present for longer than a year are less likely to heal. Venous ulcers also typically have high recurrence rates, though compression therapy and surgery can decrease these rates.

6. Genital ulcers

Genital ulcers are sores that appear on the genitals. Common locations include the penis, scrotum, anus, and vulva.

Causes

The main causes of genital ulcers are sexually transmitted infections (STIs). These include Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source :

Another cause of genital ulcers is Behçet’s syndrome, which is a rare inflammatory condition. Genital ulcers caused by Behçet’s syndrome typically occur on the penis, scrotum, or vulva.

Symptoms

The symptoms of genital ulcers will vary depending on which STI caused them. For example, the ulcer may appear Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source as a single lesion, or there may be a cluster. Ulcers may or may not hurt or itch.

It is also possible for you to develop a fever or feel generally unwell.

Diagnosis

To diagnose genital ulcers, doctors usually test for STIs. The results will help them determine the best treatment for you.

Treatment

Treatment for genital ulcers varies depending on the cause. Doctors may prescribe Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source antiviral medications, antibiotics, or pain relievers.

Outlook

The outlook for genital ulcers is good if you follow your doctor’s treatment plan. It is important to take the full course of prescribed medications.

7. Mouth ulcers

Mouth ulcers, or canker sores, occur inside your mouth. They can appear on your tongue or the inside of your cheeks or lips.

Causes

The causes of mouth ulcers include:

Symptoms

A mouth ulcer on the inside of the bottom lip
Mouth ulcers are small lesions that develop in your mouth. Tuan_Azizi/Shutterstock

The symptoms of mouth ulcers usually include one or more sores inside your mouth that may change in size. The sores may be painful, and the skin around them may look swollen.

Diagnosis

Doctors typically diagnose mouth ulcers by swabbing the ulcers to check for bacterial or viral infections. If you are feeling unwell, they may also perform blood tests.

If your doctor suspects that cancer might be causing the ulcers, they may biopsy them. This procedure involves removing a piece of an ulcer for analysis in a laboratory.

Treatment

Treatment for mouth ulcers can include:

  • applying topical corticosteroids or taking anti-inflammatory medications
  • using antibiotic mouthwash
  • avoiding foods that may worsen the ulcer
  • taking pain relievers

Outlook

The outlook for mouth ulcers is generally good. They typically clear up on their own in 1–2 weeks.

However, talk with your doctor if you have a mouth ulcer that:

  • lasts for longer than 3 weeks
  • shows symptoms of infection, such as bleeding or redness
  • keeps coming back
  • is large or near the back of your throat

Summary

There are seven common types of ulcers: peptic, esophageal, arterial, diabetic foot, venous, genital, and mouth. Ulcers are open sores that can occur internally and externally. They can be mild or serious.

The causes of ulcers can be mild or serious. Diagnosis and treatment of ulcers will vary depending on your symptoms and medical history.

If you think you have an ulcer, talk with your doctor.

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Medical Reviewer: Megan Soliman, MD
Last Review Date: 2022 Jun 6
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