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What is the Difference Between Gastritis and an Ulcer?

By T. Broderick
Updated Feb 06, 2024
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Gastritis and an ulcer are conditions that affect the stomach and small intestine, and they share many symptoms, such as abdominal pain, nausea, vomiting, loss of appetite and weight loss. There are many differences, though. Gastritis and an ulcer both inflame the stomach lining, but gastritis is a general inflammation, and an ulcer is a patch of eroded stomach lining. Although gastritis and an ulcer share symptoms, an intense, localized pain is much more common with an ulcer, and an ulcer also carries the risk of bleeding, cancer and eventual stomach perforation. Doctors use a variety of techniques to diagnose each specific ailment, and the methods of treatment vary as well.

Gastritis, an inflammation of the stomach lining, has three key primary causes. The first is excessive consumption of alcohol, which erodes the stomach's protective mucous lining and promotes the secretion of hydrochloric acid. Taking excessive doses of nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin or ibuprofen is another common cause, because these pain relievers reduce the stomach's ability to create prostaglandin, one of the stomach's lines of defense against hydrochloric acid. The third cause is a bacterial infection of the stomach lining. When bacteria are involved, gastritis can become an ulcer.

The majority of ulcers in the stomach or duodenum, the first section of the small intestine, are the result of an untreated bacterial infection. Generally, 10 percent of patients with gastritis will develop an ulcer. Doctors still disagree on whether stress plays a role in ulcer development. Ulcers can become a much more serious condition, so certain tests are required for a correct diagnosis.

Though a blood, urine or stool sample can diagnose either gastritis or an ulcer, the similarities between the conditions might require patients to undergo an endoscopy. In this procedure, patients are put under general anesthesia before a doctor inserts a narrow tube through the esophagus and into the stomach. With a camera at the end of the tube, a doctor inspects the stomach lining and duodenum. A benefit of the procedure is that if a doctor finds a suspicious-looking ulcer, he or she can immediately perform a biopsy for cancer. Though the patient is unconscious, an endoscopy carries little risk and is the most reliable diagnostic tool.

After a doctor has made a determination between gastritis and an ulcer, treatment can vary. With gastritis, simple antacids might cause permanent relief. In more serious cases, a doctor will prescribe drugs that lower the stomach's acid production. These drugs are known as proton pump inhibitors. Along with following a prescription, patients also should avoid alcohol and NSAIDs.

Antacids are another common treatment for mild ulcers. In more serious cases, a patient will take antibiotics to cure the infection that caused the ulcer. For most patients, antibiotics lead to a full recovery. If the ulcer is bleeding or has perforated the stomach, doctors will perform endoscopic surgery to correct the condition.

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