Duodenal Ulcer vs. Gastric Ulcer: Understanding the Key Differences

When it comes to digestive health, ulcers are a common concern. Among them, duodenal ulcers and gastric ulcers are two major types that fall under the category of peptic ulcers. While they share some similarities, there are also significant differences between the two.

1. Location of the Ulcer

A duodenal ulcer occurs in the duodenum, which is the first part of the small intestine. These ulcers most commonly develop in the duodenal bulb. In contrast, a gastric ulcer forms inside the stomach, typically along the lesser curvature of the stomach near the pylorus or in the gastric angle.

2. Symptoms and Pain Patterns

One of the most notable differences lies in the pattern of pain experienced by patients. Those with a duodenal ulcer often feel upper abdominal pain that worsens when the stomach is empty and improves after eating. This discomfort can also occur at night and may wake the person from sleep.

On the other hand, individuals with a gastric ulcer usually experience pain 1–2 hours after eating. The pain tends to be relieved by acid-reducing medications such as proton pump inhibitors (PPIs) or antacids.

3. Common Age Groups Affected

Duodenal ulcers are more frequently seen in younger individuals, especially those in their 30s and 40s. Meanwhile, gastric ulcers tend to affect older adults, particularly those over the age of 50.

4. Risk of Cancer and Disease Progression

There is a key difference in the potential for malignancy between these two ulcer types. Duodenal ulcers have a very low risk of becoming cancerous, and during endoscopic examination, biopsies are usually not required unless unusual features are present.

However, gastric ulcers carry a higher risk of being associated with gastric cancer. For this reason, doctors often perform a biopsy during endoscopy to rule out cancer and differentiate benign peptic ulcers from malignant ones. Additionally, patients diagnosed with gastric ulcers are advised to undergo a follow-up endoscopy after 2–3 months of standard treatment to ensure proper healing.

In conclusion, while both duodenal and gastric ulcers are forms of peptic ulcers, understanding their differences in location, symptoms, affected populations, and long-term risks is essential for accurate diagnosis and effective treatment. Proper medical evaluation and follow-up are crucial, especially for gastric ulcer cases due to their association with cancer.