7 Types of Ulcers: Symptoms, Treatment, and More

• Ulcers are wounds that happen due to eroding tissue. They often are shaped like craters and can appear in most places on the body
• The most common type of ulcer is peptic, which occurs in the stomach lining or small intestine.
• Causes and treatment of ulcers depend on the type and the underlying issues.

An ulcer is a wound, usually shaped like a crater, that occurs due to tissue eroding. They can appear anywhere on the body, inside or outside, and take a long time to heal.

There are different types of ulcers that can appear, as well as multiple causes for them to occur. Some ulcers can heal on their own, while others may require medical treatment.

There are multiple types of ulcers, the most common of which are peptic, mouth, and arterial.

Peptic Ulcer

Peptic ulcers appear inside the body, specifically in areas such as the stomach lining, the esophagus, or the upper part of the small intestine. They may also be called ​“gastric ulcers” or ​“peptic ulcer disease.” These ulcers usually occur when stomach acid or the digestion process damages the stomach or small intestine due to an H. pylori bacterial infection or long-term use of Nonsteroidal Anti-Inflammatory Drugs (NSAIDs).

There are two types of peptic ulcers: stomach ulcers and duodenal ulcers.

• Stomach Ulcer: also called a gastric ulcer, this type develops along the lining of your stomach.
• Duodenal Ulcer: this type of ulcer develops in the small intestine, also called the duodenum.

Esophageal Ulcers

Esophageal ulcers appear on the lining of the esophagus, usually due to damage done to the esophagus.

The most common cause of esophageal ulcers is gastroesophageal reflux disease (GERD), also known as acid reflux. When acid from the stomach backs up into the esophagus, it can damage the lining, causing an ulcer to appear. 

Mouth Ulcers

Mouth ulcers, also called canker sores, form inside the mouth or along the baseline of the gums.

Canker sores typically go away on their own, though certain conditions may cause them to occur repeatedly, such as an allergic reaction or a family history of canker sores. Causes for mouth sores may vary, but the most common include:

• Vitamin deficiencies, such as iron, zinc, or folic acid
• Hormone changes
• Mouth injuries
• Weakened immune system

Arterial Ulcers

Arterial ulcers are skin ulcers that usually form along the ankles, heels, toes, or feet. They may also be referred to as ischemic ulcers.

The most common cause of arterial ulcers is poor blood circulation due to conditions such as:

• Periphery artery disease (PAD), 
• Diabetes, 
• High blood pressure
• High cholesterol
• Smoking
• Atherosclerosis 

Diabetic Foot Ulcers

Similar to arterial ulcers, a diabetic foot ulcer is an ulcer that occurs on the bottom of the foot. 

The leading causes of diabetic foot ulcers include:

• Unchecked diabetes
• Peripheral artery disease (PAD)
• Irregular blood sugar levels
• Nerve damage

Venous Ulcers

Venous ulcers are also skin ulcers that most commonly form along the legs. They are also called stasis leg ulcers or varicose ulcers.

Like arterial ulcers, poor blood circulation and vein damage cause venous ulcers. Some ways this can occur include:

• Smoking
• Deep vein thrombosis (DVT)
• Family history of varicose veins
• Blood clotting disorders

Your risk for an arterial ulcer may be higher if you’re a woman, pregnant, have endured previous leg trauma, are obese, or are an older adult. 

Genital Ulcers

Genital ulcers form around the penis, vagina, anus, or skin surrounding these areas.

The most common cause of genital ulcers is a sexually transmitted disease (STI), but it can also be caused by inflammatory diseases such as pelvic inflammatory disease (PIT) or trauma.

Each type of ulcer has different symptoms to look out for.

Peptic Ulcers

• Stomach pain, usually a dull, burning sensation
• Bloating
• Little/​low appetite 
• Vomiting/​nausea
• Weight loss
• Burping 

Esophageal Ulcers

• Vomiting
• Heartburn
• Nausea
• Difficulty swallowing or feeling like food is ​“stuck” in your throat
• Chest pain

Mouth Ulcers

• Pain that increases due to certain foods, such as highly acidic foods such as tomatoes, oranges, lemons, or spicy foods such as peppers
• Difficulty chewing without pain

Arterial Ulcers

• Black, red, or yellow open sores on heels, ankles, feet, or toes
• Pain in the legs or feet, especially if it worsens at night 
• A sore that doesn’t bleed
• An area that is cold to the touch due to poor circulation

Diabetic Foot Ulcers

• Calluses
• Blisters
• Wound with drainage, possibly with odor
• Swelling around the wound 
• Pain caused the open wound
• Tissue discoloration (usually brown or black)

Venous Ulcers

• Dark purple or red skin 
• Thickened skin
• Skin that is overly dry 
• Itching on the legs 
• Dull aching 
• Swelling 
• Varicose veins

Genital Ulcers

Signs of genital ulcers most commonly include painful sores around the genital area, as well as fluid that seeps from the wound. Other possible symptoms include:

• Swollen glands in the groin area
• Rash or bumps
• Itching/​sensitivity
• Fever

Treatment for ulcers depends on the type of ulcer as well as the root cause of the ulcer.

Peptic Ulcers

Peptic ulcers can often be caused by taking NSAIDs, increased stomach acid, or, occasionally, from an H pylori infection.

If NSAIDs are the issue, your healthcare provider may recommend you stop taking NSAIDs, such as ibuprofen. If you need pain relief, they may recommend an alternative to NSAIDs.

Your provider may also recommend medication that helps reduce the amount of stomach acid produced.

If the issue stems from an H pylori infection, your provider will administer antibiotics to treat the infection, which should eliminate the ulcers.

Esophageal Ulcers

The most common approach to treat esophageal ulcers is treating the underlying conditions that caused the ulcer. In this case, your provider will provide medication to treat GERD, which involves medications that limit the amount of acid your body produces. These may be in the form of proton pump inhibitors (PPIs) or H2 blockers.

You may also need to make lifestyle changes such as quitting smoking or limiting the amount of acidic foods and beverages in your diet. 

Mouth Ulcers

Mouth ulcers usually heal on their own and do not require specific treatment. However, you may wish to take over-the-counter medicines to help alleviate symptoms, such as oral gels or mouthwashes.

Arterial Ulcers

Arterial ulcers are usually caused by poor circulation, which your healthcare provider will need to determine through tests that check for circulation, your medical history, and/​or a physical exam. In some cases, surgery may be necessary to correct the cause of the poor circulation.

Your provider may also administer antibiotics to help fight infection, though this won’t necessarily speed the wound’s healing process. It’s essential to keep the wound clean to prevent infections.

Diabetic Foot Ulcers

When treating a diabetic foot ulcer, the severity of the ulcer will determine the treatment. In many cases, your provider will administer antibiotics to help treat underlying infections that may have contributed to the ulcer. If there is extremely restricted blood flow to the foot, they may perform surgical revascularization, which restores blood flow to the foot. In extremely severe cases, amputation may be considered. 

Venous Ulcers

Similar to arterial ulcers, venous ulcers are often caused by poor circulation, with a focus on the lower legs. Compression therapy, such as compression socks or stockings, can help increase circulation and prevent or treat venous ulcers.

Genital Ulcers

Allergic reactions or an STI usually causes genital ulcers. If the issue is an allergic reaction, then stopping the use of the product causing the irritation should result in the ulcer healing.

If the ulcer results from an STI, your provider must determine the type of STI and administer treatment accordingly.

If left untreated, ulcers can result in complications. The type and severity of the ulcer determine the specific kind of complications.

Peptic Ulcers

If left untreated, complications of a peptic ulcer may include:

• Internal bleeding (if the peptic ulcer bleeds into the body, it may cause anemia)
• Perforation (hole) in the stomach wall
• Gastric cancer
• Obstruction of the digestive tract, making it impossible for food to pass through

Esophageal Ulcers

If left untreated, esophageal ulcers may result in complications such as:

• Esophageal cancer
• Rupture of the esophagus 
• Recurrent peptic ulcers
• Excessive weight loss due to the inability to swallow food
• In rare cases, upper gastrointestinal bleeding

Mouth Ulcers

Most mouth ulcers heal on their own. However, if they refuse to heal and are left untreated, complications can include:

• Dental infections
• Oral cancer
• Cellulitis of the mouth (due to bacterial infection)

Arterial Ulcers

Arterial ulcers left untreated can result in significant complications, including:

• Infection
• Tissue necrosis (death of cells in your body)
• In severe cases, amputation of the affected limb

Diabetic Foot Ulcers

In extremely severe cases of diabetic foot ulcers, foot amputation may need to occur to prevent infection from spreading in the body. 

Venous Ulcers

Untreated venous ulcers most commonly can result in infections, such as:

• Bacterial viruses
• In severe cases, osteomyelitis(bone infection) or septicemia (blood poisoning)

Genital Ulcers

If genital ulcers are left unexamined or untreated and result from an STI, complications may include worsening of the STI, which can lead to pain, infertility, and/​or certain cancers depending on the specific STI.

Healing depends on the cause and type of ulcer, but in many cases, ulcers go away with proper treatment. Some ulcers, such as peptic or genital, may heal but recur even after treatment especially if the underlying cause of the ulcer isn’t addressed. Mouth ulcers may heal quickly but have the possibility of recurring because of mouth injury or genetic history of mouth sores. 

Talking with your healthcare provider about any chronic ulcers or symptoms you have can help determine the root cause, which can help prevent or heal ulcers.

Can ulcers heal on their own?

Some ulcers, such as mouth ulcers, heal independently without much intervention. Other ulcers, particularly those caused by infections, require treatment and antibiotics to help fight the infections and prevent further complications.

Can stress cause a stomach ulcer?

While stress and anxiety cannot cause a stomach ulcer, they can weaken your immune system and make it difficult for your body to fight off infections, which could leave you susceptible to stomach ulcers.

What should I eat or drink if I have an ulcer?

Water is the best thing you can drink when dealing with a peptic or mouth ulcer, though bland foods such as milk/dairy, herbal teas, rice, pasta, bananas, and potatoes are all beneficial.