There are four types of stomach ulcers. Each type occurs on a different part of the stomach lining. These are different from duodenal ulcers, although they develop nearby and have similar causes and symptoms.

Stomach ulcers, also called gastric ulcers, are sores that form in the stomach lining.

Stomach ulcers are most commonly the result of inflammation from infection with Helicobacter pylori (H. pylori) bacteria or through long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs).

Men over age 60 are more likely to get stomach ulcers, but they can occur in people of any sex or age.

Doctors may classify stomach ulcers based on their location in the stomach. Treatment for all types of stomach ulcers usually involves antibiotics and medications to reduce stomach acid.

Is there a difference between a stomach ulcer and a peptic ulcer?

A stomach ulcer is a type of peptic ulcer. Peptic ulcers also include duodenal ulcers, which form on the upper part of the small intestine.

It’s possible to have both stomach and duodenal ulcers at the same time. These are known as gastroduodenal ulcers.

Doctors classify gastric or stomach ulcers into four types, depending on their location in the stomach:

  • Type 1: Type 1 gastric ulcers form near the lesser curvature — the short, curved, right border of the stomach. This is the most common place for a gastric ulcer to form.
  • Type 2: Type 2 gastric ulcers are usually found near the duodenum or pyloric channel, where the stomach meets the upper part of the small intestine (duodenum). Type 2 gastric ulcers co-occur with ulcers in the duodenum.
  • Type 3: Type 3 ulcers are found in the prepyloric region of the stomach, which is located just above the pylorus. The pylorus is the opening to the small intestine.
  • Type 4: Type 4 gastric ulcers form higher up on the lesser curvature of the stomach near the cardia. The cardia is the part of the stomach that is closest to the esophagus.

The main symptom of a stomach ulcer is a gnawing or burning pain in the middle of the stomach. But not all stomach ulcers are painful. Some ulcers don’t cause any symptoms until they lead to complications.

Unlike types 1 and 4 stomach ulcers, types 2 and 3 stomach ulcers also cause the body to secrete excess stomach acid. Symptoms of excess acid secretion may include:

A duodenal ulcer is a peptic ulcer that forms in the first part of the small intestine (duodenum). Like gastric ulcers, the most common causes of duodenal ulcers are H. pylori infection and a history of heavy NSAID use.

Duodenal ulcers don’t always cause symptoms. If they do, symptoms may include stomach pain, bloating, nausea, and vomiting.

You can’t always tell the difference between a duodenal ulcer and a gastric ulcer based on symptoms alone. However, eating a meal will usually help relieve pain from a duodenal ulcer but will typically worsen pain from a gastric ulcer.

The type of stomach ulcer usually doesn’t affect treatment. If the ulcer is due to an H. pylori infection, treatment will involve antibiotics and proton pump inhibitors (PPIs), which are medications that reduce acid secretion.

As the ulcer heals, a doctor may also recommend avoiding certain foods, like coffee, spicy foods, and alcohol.

If a gastric ulcer is due to long-term use of NSAIDs, your doctor will ask you to stop taking the NSAID to allow the ulcer to heal.

If an ulcer doesn’t heal after 12 weeks or you experience complications, you might require surgery to remove the ulcer and stop acid secretion. The exact type of surgical technique your surgeon uses may vary depending on the type of stomach ulcer you have.

Most stomach ulcers will go away with time and medical treatment, regardless of the type.

If not treated, stomach ulcers can cause complications like:

  • bleeding as the ulcer wears away the stomach lining
  • perforation, when the ulcer becomes deep enough to cause a hole through the wall of your stomach
  • blockage caused by scar tissue

Gastric ulcers can also increase your risk for stomach cancer.

If a stomach ulcer requires surgery, the type of stomach ulcer could affect the outlook. For example, type 4 ulcers may be more challenging for a surgeon to operate on due to their location high along the lesser curvature of the stomach.

There are four types of gastric ulcers, and the type depends on the location in the stomach. The cause, symptoms, and treatment are similar for all types. But if your gastric ulcer is severe enough to need surgery, doctors will consider the type before deciding how to operate.

Most stomach ulcers will heal over time with treatment but can lead to complications if left untreated for too long. Talk with a doctor if you’re experiencing stomach pain before or after meals or have heartburn regularly.