Equine gut health, horse digestive health, ulcer treatment.

Gastric ulcers in horses, commonly referred to as Equine Gastric Ulcer Syndrome (EGUS), have become a prevalent concern for horse owners and veterinarians alike. This condition encompasses a range of mucosal disruptions, from erosions to ulcerations, affecting various parts of the equine digestive system.

Understanding EGUS: A Closer Look at Gastric Ulcers

EGUS is a collective term that describes disruptions in the terminal esophagus, non-glandular squamous, glandular regions of the stomach, and the proximal duodenum. These disruptions can manifest as erosions, ulcerations, or lesions.

Who is at Risk of Gastric Ulcers in Horses?

Performance horses and foals are particularly susceptible to EGUS.

Factors that elevate the risk include:

  • Involvement in high-intensity disciplines
  • Diets rich in concentrates (grains)
  • Intermittent feeding patterns
  • Environmental stressors, such as confinement
  • Travel-induced stress or social interaction challenges
  • Underlying illnesses

Prevalence of Gastric Ulcers in Horses (EGUS)

The prevalence of EGUS varies based on the horse’s activity:

  • Racehorses: Approximately 90% of racehorses in active training and racing are affected.
  • Non-racing Performance Horses: The prevalence ranges between 40% to 60%.
  • Neonatal Foals: Estimates suggest that 25% to 50% of neonatal foals are affected.

Anatomical Distribution of Horse Gastric Ulcers

Endoscopic surveys have revealed that:

  • 80% of lesions are found in the non-glandular squamous mucosa of the stomach, especially near the lesser curvature.
  • 20% of lesions are located in the glandular region of the stomach.

Duodenal ulceration, both in adult horses and foals, is considered a component of EGUS, often resulting from peptic acid-induced disorders.

Causes and Mechanisms of Horse Gastric Ulcers

Equine Squamous Gastric Ulcer Disease

This condition arises from the erosive effects of extremely low pH fluid found in the glandular region of the stomach. During intense exercise, the acidic contents of the stomach come in contact with the non-glandular squamous mucosa, leading to inflammation and potential ulceration.

Dietary Implications

Diets high in concentrates and low in roughage produce short-chain fatty acids (SCFAs) due to sugar fermentation. These SCFAs can lead to cellular acidification, resulting in ulceration. Conversely, alfalfa hay, rich in protein and calcium, acts as a dietary buffer, preventing ulcer formation.

Equine Glandular Gastric Disease

The causes of ulcers in the glandular mucosa are less defined. Potential factors include:

  • Breakdown of mucosal defenses
  • Bacterial colonization
  • Environmental and psychological stress
  • Inflammation

Gastric Ulcer Clinical Manifestations

In Foals

Foals with EGUS typically exhibit:

  • Lethargy
  • Colic symptoms
  • Unthrifty appearance
  • Diarrhea
  • Interrupted nursing patterns
  • Bruxism and ptyalism

In Adult Horses

Adult horses with EGUS may display:

  • Poor performance
  • Abdominal discomfort
  • Appetite loss
  • Weight loss
  • Behavioral changes

Diagnosis and Treatment of Horse Gastric Ulcers

While clinical signs can provide clues, definitive diagnosis requires endoscopic visualization of the ulcers. Treatment primarily focuses on increasing gastric pH using pharmaceutical agents like omeprazole.

Other treatments include synthetic prostaglandins and coating agents such as sucralfate.

There is also an option to try natural and more friendly treatment options:

  1. Supporting Natural Healing: Pairing herbal treatments with a natural diet effectively combat ulcers.
  2. Aloe Vera: Reduces stomach acid and soothes the digestive tract.
  3. Herbal Arsenal: Slippery Elm, Fenugreek, Ginger, Lemon Balm, Mint, and Chamomile offer varied ulcer-relief properties.
  4. Grazing Insight: Horses naturally graze for 12 hours; their stomachs need frequent meals to prevent acid-induced ulcers.

Check out this Medrego article addressing the Natural Ways to Treat Horse Ulcers.

Effective and Natural Horse Gastric Ulcer Supplement

Medrego knows the pain of the Horse Gastric Ulcer challenge, so we are bringing you natural remedies to address the challenge and support your hore digestive system.

Meet Black Balance Supplement.

Black Balance by Medrego is a very potent prebiotic that promotes the vitality of beneficial microbes and improves intestinal well-being for horses.

Black Balance by Medrego prebiotics for horses

Black Balance Supplement will:

  1. Improves the work of the stomach and intestinal microbiome.
  2. Improves absorption of nutrients from the gastrointestinal tract.
  3. Removes heavy metals and free radicals out of the body.


Understanding and addressing EGUS is crucial for maintaining the health and performance of horses. With timely diagnosis and appropriate treatment, the adverse effects of this condition can be mitigated, ensuring the well-being of these majestic creatures.

The Medrego team always suggests consulting a qualified veterinarian for personalized advice.


  • Andrews FM, Larson C, Harris P. “Nutritional management of gastric ulceration.” Equine Vet Educ 2017.
  • Sykes BW, Hewetson M, Hepburn RJ, et al. “European College of Equine Internal Medicine Consensus Statement—Equine gastric ulcer syndrome in adult horses.” J Vet Med 2015.
  • Camacho-Luna P, Buchanan B, Andrews F. “Advances in diagnostics and treatments in horses and foals with gastric and duodenal ulcers.” Vet Clin North Am Equine Pract 2018.
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Vet MD. Being a veterinarian is my current profession, but living with animals is my biggest passion. I love cats, dogs, and horses and always strive to bring the best solution to each animal. 🐕 🐎 🌎