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Meaning of an ulcer: Types of ulcers, causes and symptoms

Ulcers can occur in different places in the body and share some similar causes and symptoms. Learn about the different types of ulcers, their causes and symptoms.

A woman with mouth ulcer showing the sore on her lips

Key Takeaways:

  • Ulcers are wounds or open sores that can develop in different parts of the body, such as the legs and feet, stomach, eye, genitals, and esophagus.
  • There are different types of ulcers, including leg and foot ulcers, stomach ulcers, and mouth ulcers. These ulcer types are named depending on where the sores develop.
  • Bacteria, viruses, physical trauma, and health conditions can cause or increase the risk of ulcers; however, they are treatable when you see a healthcare provider.

Ulcers are wounds that can occur in different places in the body. They are mostly caused by bacteria infections and can be painful and discomforting.

However, most ulcers heal completely when treated early and properly.

There are different types of ulcers sharing similar causes and symptoms, and you may not be able to differentiate between these symptoms until you visit your doctor. For instance, esophageal ulcers and stomach ulcers share similar causes and symptoms. Seeing a healthcare professional is the only way to ensure you get proper diagnosis and treatment.

Also, some ulcers can result from underlying health conditions, leading to more severe conditions when not treated.

In this article, we'll discuss the different types of ulcers and their causes. We'll also talk about when to see a doctor for ulcer-related issues.

Meaning of an ulcer

Ulcers are wounds or sores that occur in different parts of the body. They are wounds that take a long time to heal because of abnormal or insufficient blood supply, nerve damage, or wound infection.

Some ulcers occur in visible parts of the body, like your leg and hands, while some can occur in the internal parts of the body, such as the gastrointestinal tract.

Ulcers can become infected when not treated properly. There are different causes of ulcers; likewise, their treatments vary depending on the cause and type of ulcer.

Types of ulcers and causes

Some of the common types of ulcers include:

1. Leg and foot ulcer

Leg and foot ulcers are open wounds or sores that form in your leg and foot. Sometimes this leads to infections and gets severe when not treated. Leg ulcers most times don't cause pains, especially when it occurs due to some nerve problems. And because of that, those affected may not go for treatment. The result is that the ulcer worsens, leading to an infection.

People with health conditions like diabetes, kidney disease, infections, and high cholesterol are at higher risk of developing leg and foot ulcers.

Leg and foot ulcers can be categorized into neurotrophic or arterial ulcers.

  • Neurotrophic ulcers

Neutrophils are phagocytes that trap microorganisms present in wounds, killing them. However, when produced at high levels, it can lead to the development of neutrophilic ulcers.

This type of ulcer affects people with impaired foot sensation, although it commonly affects people with diabetes. It doesn't cause pain but can lead to complications when not treated.

  • Arterial ulcers

Arterial foot ulcers occur when there is reduced blood flow to your leg through the arteries. People with diabetes and those who smoke are more prone to arterial ulcers. Arterial ulcers can occur on your heels, tips of your toes, between your toes, and on your nail bed.

Causes of leg and foot ulcers

Some of the common causes of leg and foot ulcers include:

  • A bacterial infection known as cellulitis
  • Trauma to the foot or toe
  • Pressure on the leg or toe due to excessive work
  • poor circulation of blood to the legs and feet
  • An injury to the lower limb

Complications of foot ulcers

Complications of foot ulcers are common among people with untreated foot ulcers and those with health conditions such as diabetes. When left untreated for long, leg and foot ulcers can lead to complications like skin infection, foot amputation, gangrene, sepsis, and leg and foot deformities.

2. Stomach ulcer

Stomach ulcers are painful sores that affect the lining of the stomach and intestines. A stomach ulcer, also called a gastric ulcer, is a type of peptic ulcer disease (ulcers that affect the inner lining of the lower esophagus, the stomach, and the small intestine).

Contrary to popular belief, skipping meals does not cause stomach ulcers. Rather, stomach ulcers occur when digestive acids damage the stomach lining and the thick layer that protects the stomach.

Some stomach ulcers can go unnoticed for a long time until it starts causing severe symptoms like bleeding. However, it's rare to develop such stomach ulcers.

In more common cases, stomach ulcers can cause the formation of holes in the stomach wall. They can also present with symptoms like weight loss, nausea, bloating, constipation, heartburn, and pain in the upper abdomen.

While foods do not directly cause stomach ulcers, foods play a role in worsening or reducing the symptoms. If you have stomach ulcer, it will be helpful to find out the foods that promote stomach ulcer healing and are good for ulcer patients.

Causes of stomach ulcers

There are two main causes of stomach ulcers:

  • Helicobacter pylori bacterial infection
  • Long-term use of nonsteroidal anti-inflammatory drugs (NSAIDS).

When not treated, stomach ulcers can lead to a stomach infection and increased pain.

3. Esophageal ulcer

An esophageal ulcer is a sore in the lining of the lower part of the esophagus. It is also a type of peptic ulcer.

The esophagus is the narrow tube that connects the throat to the stomach. Esophageal ulcers typically occur at the lower part of the esophagus - the junction between the stomach and esophagus.

Symptoms of esophageal ulcers include indigestion, nausea, bloating, lack of appetite, heartburn, and vomiting. Some people also experience esophageal ulcers without any obvious symptoms.

People at more risk of developing esophageal ulcers are people who constantly take alcohol, people with too much calcium in their blood, or those who take steroids often.

Causes of esophageal ulcer

Esophageal ulcers share similar causes as stomach ulcers. Causes of esophageal ulcers include:

  • Helicobacter pylori which damages the esophageal lining
  • Gastroesophageal reflux disease (GERD) - a disease that occurs when stomach acid repeatedly flows back into the esophagus
  • The excessive use of non-steroidal anti-inflammatory drugs like ibuprofen and aspirin
  • Too much alcohol consumption and smoking

4. Eye ulcer

An eye ulcer (corneal ulcer) is also known as keratitis. It is an ulcer or sore that occurs in the cornea, the clear layer over the iris (2) This type of ulcer is common in people who wear contact lenses.

Eye ulcers, when not treated, are a big threat to vision.

Corneal ulcer presents symptoms like severe pain in the eye, redness, tears, swollen eyelids, and blurred vision.

Causes of corneal or eye ulcer

Different things can cause corneal or eye ulcers, such as:

  • Infections from fungi like Fusarium, Aspergillus, or candida - these infections are rare and are often caused by an injury to the eye
  • Bacteria infections
  • Infection by parasites like Acanthamoeba (commonly found in dirt and freshwater)
  • Viral infections like herpes simplex virus, which causes cold sores, or the varicella virus, which causes shingles and chicken pox
  • Disorders that lead to dry eyes, such as some autoimmune diseases
  • When the eyelashes grow inward
  • Excessive use of steroid eyedrops
  • Exposure of the eye to dryness due to weakness of eyelid muscles as seen in Bell's palsy

5. Mouth ulcer

Mouth ulcers are lesions or sores that occur in the mouth, tongue, inner cheeks, lips, or base of the gum. They include canker sores (painful, non-contagious sores that develop inside the mouth).

Canker sores are of three types, minor, major, and herpetiform.

  • Minor canker sores can heal within one to two weeks without leaving any scar.
  • Major canker sores are bigger than minor and take several weeks or months to heal while leaving scars behind.
  • Herpetiform sores have almost the same appearance as the sores caused by herpes. They occur in tiny forms and can sometimes combine to form a large sore in the tongue. They can heal within one month without leaving any scars.

These sores on the mouth are often painful and cause great discomfort while eating, drinking, or talking. The sores may be yellowish, reddish, or whitish. In some cases, mouth ulcers may heal on their own after a while, even without treatment.

Causes of mouth ulcer

There are no definite causes of mouth ulcers, but some factors can contribute to or trigger their formation.

Some of the factors that can lead to mouth ulcers include:

  • Oral bacteria
  • Deficiency of some essential nutrients like vitamin B9, Vitamin B12, iron, and zinc.
  • Viral, bacteria, or fungal infections.

Health conditions associated with mouth ulcers include:

  • Diabetes
  • HIV
  • Inflammatory bowel diseases like ulcerative colitis
  • Celiac disease

6. Genital ulcer

Genital ulcers are sores that form on the anus, penis, outer part of the vagina, or skin near the genitalia areas.

Genital ulcers initially appear as small bumps or rashes in your genital area. It can also appear as swollen lymph nodes in the groin.

When you have a genital ulcer, it can be accompanied by fever, itchy genitals, painful urination, or burning sensations.

Causes of genital ulcers

Genital ulcers can be caused by some medical conditions like:

  • Contact dermatitis
  • Pemphigus
  • Cancer of the vulva
  • Vaginal yeast infections
  • Genital ulcers can be caused by some sexually transmitted infections like:
  • Genital herpes
  • Chlamydia
  • Syphilis
  • HIV

A genital ulcer can also be due to non-sexual causes like:

  • Cytomegalovirus
  • Influenza A, group A Streptococcus
  • Varicella zoster (that causes chickenpox)
  • Bacteria like Mycoplasma pneumonia and group A Streptococcus

Genital ulcers can be caused by stress and traumas that affect the genital area, such as:

  • Sexual injury due to aggressive sex
  • Using lotions, hair removal creams, and products that cause a chemical burn.
  • Wearing tight undergarment

When to see a doctor for an ulcer

Ulcers can be painful irrespective of where they occur. Also, when an ulcer goes untreated for a long time, it can lead to more severe complications. One common characteristic all ulcers share is the formation of sores which may be slow-healing and painful.

If you notice such sores that have refused to heal, you should see your healthcare provider, whether they are painful or not. For ulcers like the stomach and esophageal ulcers, which occur within the internal organs, you should see your doctor if you notice symptoms like a sharp or dull pain in the abdomen, nausea, heartburn, bloating, weight loss, and intolerance to fatty foods.

Your doctor will diagnose and treat you depending on your medical history, the type of ulcer, its cause, and the signs and symptoms you experience.

If you are have been diagnosed with stomach ulcer, you should take care not to eat foods that will worsen your symptoms. Discover some foods that may be best for ulcer patients.

References

  1. Ahmed F et al.,(2015). Corneal Abrasions and Corneal Foreign Bodies (6)
  2. Byrd LB and Martin N., (2021). Corneal Ulcer (5)
  3. Chiejina M and Samant H. (2022). Esophageal Ulcer(4)
  4. Judi C. McDaniel et al., (2013). Neutrophil activity in chronic venous leg ulcers—A target for therapy? (2)
  5. Malik TF et al., (2022). Peptic Ulcer Disease (3)
  6. Pendsey SP., (2010). Understanding diabetic foot (1)
  7. Roett MA., (2020). Genital Ulcers: Differential Diagnosis and Management