equine gastric glandular syndrome treatment

Equine Gastric Glandular Disease (EGGD) is defined as ulceration in the horse’s stomach in the ventral glandular region. It is also known as equine gastric glandular syndrome due to its complicated nature and many causes.

This condition was not previously known, but the equine squamous gastric syndrome was well known. It is due to the endoscope that was used for diagnosis and was only 2.5 meters long. That endoscope could not see into the pyloric antrum.

The equine gastric glandular disease is present in the pyloric antrum. With the advancement of science and after discovering a three-meter long endoscope, it is possible to fully observe the entire stomach of equines.

After multiple investigations, the incidence of gastric ulcers was also found to be much higher than everyone previously believed.

The equine gastric glandular syndrome is different from equine squamous gastric syndrome (EGSD) in terms of risk factors, pathophysiology, and treatment. However, the absence or presence of one disease has no effect on the absence or presence of another disease.

In this article, we will discuss in detail what EGGD is, its pathophysiology, risk factor for getting EGGD, and how to treat it.  

What is Equine Gastric Glandular Syndrome (EGGD)?

The horse’s stomach is made up of two distinct regions, the glandular mucosa, and the squamous mucosa, separated by Margo plicatus. The Squamous cell epithelium covered the dorsal portion of the stomach. The central portion of the stomach is covered by glandular mucosa.

The ventral portion comprises gastric glands that secrete histamines, hydrochloric acid, pepsinogen, sodium bicarbonate, and mucous.

The diseases of the stomach of the horse are differentiated by region.

If the gastric ulcers exist in a glandular portion in the stomach’s ventral region, then it is called an equine glandular gastric syndrome (EGGD).

When the disease affects the squamous portion, it is called equine squamous gastric syndrome (EGSD). The term equine gastric ulcer syndrome (EGUS) refers to disease of any portion of the stomach.

Causes of EGGD

There are two factors that result in the cause of EGGD. The first factor contributing to the cause of the disease is the degradation of bacterial colonization, mucosal defense, inflammation, and stress.

The other factor is that the glandular mucosa is constantly exposed to hydrochloric acid. There are not many protective factors present to protect the mucosal damage of the glandular region compared to squamous cell epithelium.

Therefore, it is considered that there are two factors responsible for causing EGGD. One is the exposure to hydrochloric acid, and the other is the breakdown of the protective factors.

Clinical Signs of Equine Gastric Glandular Syndrome

In the case of EGGD, clinical signs are present regardless of the intensity of exercise. Common clinical signs that appear in EGGD are:

  • Loss of appetite;
  • Changes in hair coat;
  • Weight loss;
  • Underperformance;
  • Poor behavior;
  • Stereotypies such as weaving, cribbing, or wood chewing.

Sometimes diarrhea and girthiness are present along with the signs of EGGD. These are the signs of a problem in the large intestine. If you found any of these signs after EGGD conformation by endoscopy, further differential diagnosis is needed to treat the hindgut problem.

Diagnosis of Syndrome

EGGD is not diagnosed based on its clinical signs because they are not considered reliable. The response of salivary cortisol and blood sucrose to adrenocorticotropin (ACTH) was considered useful in diagnosing EGGD. However, modern studies show that both tests are not reliable.

The only reliable test for the diagnosis of EGGD is the endoscopic examination.

It allows visualization of the lesion for a definitive diagnosis.

Risk Factors and Prevalence of Gastric Glandular Syndrome

The prevalence of EGGD is variable and depends on different factors. Many studies are done around the world, and the results were different. In Australia, EGGD is reported in 47% to 62% of racehorses. In Denmark, it is found in 27% -33% in endurance and 57% of the mixed horse population.

Another study that was done on thoroughbred horses identifies the risk factors associated with EGGD.

It was found that the risk increases with different trainers, horse gender, horse not fed hay, no grass turn out, horses in close contact with each other, horses fed raw grain, and incomplete diet.

These horses do swimming and inn those horses that do strenuous exercise a few days a week.

Treatment of the Equine Gastric Glandular Syndrome

Depending on the risk factors involved in the disease, reducing the duration of exercise can help slow the development of the disease. Other than that, if you can minimize the horse’s stress condition, it will result in decreased EGGD formation.

According to a recent study, the main purpose is to evaluate the risk factor associated with EGGD. In the final stage, the dietary factor was not considered a main factor in the control of EGGD compared to ESGD. However, these studies suggest that the increase in the frequency of concentrate/grains feeding and the decrease in the share of pastures are related to EGGD.

So in EGGD management strategies, decreasing grain concentrates and increasing pasture share can be useful factors.

Gut supplements

Another, natural, way how to help your horse is with Black Balance supplements by Medrego. They have been developed to balance the intestinal microbiome as close to its natural state as possible. It is done by using only natural ingredients such as fulvic and humic acids.

They are improving the work of the stomach and intestinal microbiome. Also, absorption of nutrients from the gastrointestinal tract, and removing heavy metals and free radicals out of the body.

Black Balance by Medrego has shown improvement and even complete healing of squamous and glandular stomach ulcers after a 3 month trial period.

In terms of treatment, most people use omeprazole in EGGD. However, it is not as helpful as for squamous ulceration. In many trials, it has been found that in 30-35 days of treatment with omeprazole, only 28% healing is found in the case of EGGD. Meanwhile, in the case of squamous ulceration, this treatment has a 78% healing rate in the same time interval.

Basically, omeprazole’s job is to suppress acid production for about 12 hours, which can promote healing and provide relief from squamous ulceration. However, in the glandular region, it is not as effective.

Omeprazole remains the recommended treatment for equine gastric glandular syndrome but always uses it with a mucosal protectant. If bacteria are involved, use it with antibiotics. There are two options available in the case of mucosal protectant.


Its function is to increase the whole mucosal secretion.


Its purpose is to adhere to the ulcerated mucosa, improve blood flow in that area, and stimulate mucus secretion.

Most veterinarians advise against using any of the treatments alone because they will not give the desired result.

Therefore, always use it in combination with omeprazole and mucosal protector. 


Equine gastric glandular disease, also known as an equine gastric glandular syndrome, is a common problem in foals and horses. Its clinical signs are not specific so it is only diagnosed by endoscopy. Always consult your vet before using any medication to avoid any problems.

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