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Types of Ulcers

Types of Ulcers

Ulceration is widely believed to be attributed to a stressful lifestyle and the dietary habits of the modern world. This HealthHearty article not only explains about some of the different types of ulcers, but also debunks some popularized myths about them.
Debopriya Bose
Last Updated: Apr 9, 2018
Did You Know?
❝About one in 10 Americans develops at least one ulcer during his or her lifetime.❞
― Johns Hopkins Medicine

Ulcers are usually formed on the skin or the area that has a mucous membrane. They are lesions or sores that occur due to the loss of tissue. Peptic ulcers are the most common types of ulcers. Other than those, ulcers in the mouth, genitals, feet, and legs are also observed among many.
There are different reasons as to why these ulcers may form in the body. Until the mid-1980s it was believed that peptic ulcers were formed due to stress and unhealthy eating habits. However, recent research states otherwise. It is now clear that these are just the aggravating factors, not the causal factors. While a majority of ulcers found in the digestive tract occur due to an infection caused by the bacteria Helicobacter pylori (H. pylori), other health conditions such as diabetes, artery disease, venous disease, etc., can also cause these lesions on the legs and feet. The following section explains the different types of ulcers, their causes, symptoms, and possible treatment options.
Different Types of Ulcers Explained

Definition - The term is collectively used for ulcers that form on the lining of the stomach, esophagus, and the upper portion of the small intestine called duodenum. Ulcers that form inside the stomach are called gastric ulcers. The ones that are formed inside the esophagus are called esophageal ulcers, and those that occur inside the duodenum are called duodenal ulcers. These may also bleed as they worsen with time.
Causes - Helicobacter pylori bacteria, continual use of pain killers including aspirin and ibuprofen, medications consumed for osteoarthritis, and potassium supplements.
Symptoms - Off-and-on pain that occurs anywhere between the navel and the breastbone, vomiting (with or without blood), nausea, unexplained weight loss, dark-colored (bloody) stools, pain usually flares during the night or when on an empty stomach.
Treatment - A combination of antibiotics to kill the causal bacteria and medications to reduce acid production, stabilize the stomach acid, and promote healing.

Definition - Also known as aphthous ulcers, these are usually formed on the inside of the cheeks or the lower lip. According to WebMD, "Up to 1 in 5 people get recurrent mouth ulcers." The different kinds of mouth ulcers include: Minor, major, and herpetiform. Minor ulcers usually range within 2-8 mm in diameter. The major ones are comparatively bigger and deeper. Herpetiform ulcers are those that constitute of many small pinhead-sized sores, together forming a bigger sore.
Causes - Food allergy, stress, tissue injury (due to brushing, braces, or ill-fitting dentures), nutritional deficiency, gastrointestinal tract disease, consumption of medications including painkillers and beta-blockers.
Symptoms - Pain, whitish or grayish sores with red round edges anywhere in the mouth, tenderness, loss of appetite, fever and swollen lymph nodes (in extreme cases).
Treatment - Usually, minor ulcers heal on their own within 2 to 3 weeks. If not, then a dentist may prescribe medications, including mouth rinse and ointments, to curb the problematic symptoms.

Definition - Painful ulceration may also occur on the genitals, which may be transmitted either sexually or could happen due to an infection or underlying health condition.
Causes - Sexually transmitted diseases (including genital herpes, syphilis, and chancroid), acute systemic illnesses (including tonsillitis, upper respiratory infection, and diarrheal illness), Epstein-Barr virus, lupus, some forms of rheumatoid arthritis, Behçet disease, and Crohn's disease.
Symptoms - Painful and elevated sores, blisters, swelling.
Treatment - Depends upon the underline cause. However, it may include antibiotics, non-steroidal anti-inflammatory drugs (NSAIDs), topical corticosteroid ointment, and more.

Definition - Leg ulcers usually appear on the skin on the inside of the lower leg, right above the ankle.
Causes - Injury or trauma on the area, bacterial infection, impaired blood flow in the legs due to venous insufficiency (attributes almost 80% of leg ulcers).
Symptoms - Swollen ankles and veins of the leg, pain, dryness, itchiness, redness, discoloration (dark red or purple), irregular borders, thick skin.
Treatment - Depending upon the cause, the treatment would aim at taking care of the underlying trigger. As a majority of leg ulcers are caused due to venous insufficiency―where the leg veins fail to return the blood to the heart, thereby forming an ulcer―treatment may include exercises, compression therapy, antibiotics, and perhaps surgery.

Definition - Depending upon the cause, foot ulcers tend to appear on the sole of the feet, heels, between the toes, tips of the toes, or on the nail bed. Neurotrophic (diabetic) ulcers and arterial (ischemic) ulcers commonly emerge on the feet.
Causes - Diabetes, arteriosclerosis, infections, certain medications, lymphedema, impairment of sensation due to poor blood circulation in the feet and legs.
Symptoms - Pain (especially during the night), swelling, redness, ulcer appears whitish-yellow when leg is kept at an elevation, discolored appearance (pinkish-red/brownish-black).
Treatment - The treatment would be based upon the underlying trigger. In case of diabetic neuropathy, the treatment would focus on relieving pain, managing blood sugar levels, and slowing the progression of ulcer formation. A combination of antibiotics, pain relievers, and other medications will be prescribed. In case of arterial diseases, the impairment would be corrected using compression techniques, exercises, medications, and possibly surgery.
Our lifestyle also plays a crucial role in what our body experiences. You would be surprised to know that, as per studies, those involved in heavy smoking are more likely to develop duodenal ulcers as compared to nonsmokers. Also, alcohol consumers are more prone to developing esophageal ulcers. Stomach ulcers are usually seen among those who consume aspirin frequently.
As you might have gauged, ulceration can be a sign of many health disorders, both acute or chronic in nature. We generally tend to take ulcers quite lightly, especially if they are in regions such as the mouth, legs, or feet. While they are likely to be a temporary occurrence with no severe causal triggers, it is still advised to get them checked by a trusted healthcare specialist, especially if they fail to heal within a week or two. Certain ulcers, such as the ones in the mouth and stomach, may also be an indication of a serious disease such as cancer. This makes early diagnosis all the more crucial. Take care.
Disclaimer: This HealthHearty article is meant for informational purposes only and should not be considered as a replacement for expert medical advice.