Gastric Ulcer Versus Duodenal Ulcer Pain: Understanding the Differences

Both gastric ulcers and duodenal ulcers are characterized by recurring upper abdominal pain that often follows a cyclical and predictable pattern. However, there are key differences between the two conditions that can help in identifying which type of ulcer may be present.

Pain Location

One of the primary differences lies in the specific location of the pain. Although both types of ulcers occur in the upper abdomen, the exact area where the discomfort is felt can vary. Gastric ulcer pain typically presents just below the sternum, in the upper middle part of the abdomen. In contrast, duodenal ulcer pain is usually felt slightly to the right of the upper abdomen, closer to where the stomach connects with the small intestine.

Pain Timing and Triggers

The timing of the pain and its relationship to eating are also distinguishing factors. Gastric ulcers often cause discomfort shortly after eating, when the stomach is producing acid to digest food. The pain may subside when the stomach is empty and return with the next meal. On the other hand, duodenal ulcers are commonly associated with hunger pains and may even wake a person at night. Eating or taking acid-reducing medications often brings relief.

Recommended Treatment Approaches

Whether dealing with a gastric or duodenal ulcer, prompt and appropriate treatment is essential. A comprehensive diagnostic approach should include a carbon-13 or carbon-14 breath test to determine if the ulcer is caused by Helicobacter pylori (H. pylori), a common bacterial infection linked to peptic ulcers.

If H. pylori is detected, a structured eradication therapy should be initiated to eliminate the infection. In addition, standard anti-ulcer treatment should be followed, typically lasting 6 to 8 weeks. This often includes the use of proton pump inhibitors (PPIs) or other acid-reducing medications to promote healing.

Importance of Follow-Up

After completing the treatment course, it's crucial to undergo a follow-up endoscopic examination to confirm that the ulcer has fully healed. This step ensures that there are no complications and that the treatment was effective.