Which type of Peptic Ulcer typically worsens in the middle of the night or during an empty stomach?

A duodenal ulcer is characterized by pain that tends to worsen at night or during periods when the stomach is empty. This is primarily due to the increased acid secretion that occurs when the stomach is empty, which can irritate the ulcerated area of the duodenum. Patients often report relief from the pain shortly after eating, as food buffers gastric acid and provides a protective effect on the ulcer.

In contrast, gastric ulcers may cause pain shortly after eating, rather than during the night or when fasting. Stress ulcers are typically associated with acute illness or significant stress and do not follow the same pattern as duodenal ulcers. Esophageal ulcers are related to esophagitis or reflux disease, causing symptoms that are usually associated with swallowing or postprandial discomfort rather than the nocturnal pain associated with duodenal ulcers. Thus, the distinct timing and characteristics of the pain in duodenal ulcers make it the correct answer in this scenario.