Gastric Ulcers / Equine Gastric Ulcer Syndrome (EGUS)

Helping Horse Owners Understand and Manage Gastric Ulcers

Supporting horse owners with practical information, management guidance and nutritional support.

Gastric ulcers are relatively common in horses, particularly where feeding, exercise, travel, stabling or other aspects of management increase exposure of the stomach lining to acid or place additional demands on its natural protective mechanisms.

The term Equine Gastric Ulcer Syndrome (EGUS) covers several forms of disease affecting different areas of the horse's stomach.

If you suspect that your horse may have gastric ulcers, speak to your veterinary surgeon. Signs alone cannot reliably diagnose EGUS, and gastroscopy is the definitive way of identifying gastric ulceration and determining which part of the stomach is affected.

[HERO GRAPHIC 1 — Understanding the Horse's Stomach & EGUS]

Purpose: Main page graphic, but also designed to work as a useful standalone educational graphic if downloaded, shared or printed.

Graphic content:

A clear, owner-friendly illustration of the horse's stomach divided into:

Squamous region — upper portion
Glandular region — lower portion
Margo plicatus — clearly labelled boundary between the two

Show stomach acid in the lower part of the stomach and illustrate how acidic stomach contents may contact the less-protected squamous region.

Include two simple labels:

ESGD — Equine Squamous Gastric Disease
Ulceration affecting the squamous region.

EGGD — Equine Glandular Gastric Disease
Disease affecting the glandular region.

Add a small management message:

Forage, feeding patterns, exercise and management can all influence gastric health.

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Practical equine health information for horse owners

⚡ Quick Facts

EGUS is an umbrella term covering disease affecting different regions of the horse's stomach.
The two main forms are ESGD and EGGD.
Horses continually produce gastric acid, including when they are not eating.
Long periods without forage can increase the exposure of the stomach lining to acid.
Exercise, intensive training, travel, stabling, diet and management may all influence gastric health.
Signs can be subtle and are not specific to gastric ulcers.
Some horses with ulcers show few obvious outward signs.
Gastroscopy is the definitive method of diagnosis.
Veterinary treatment and management changes are often used together.
Nutritional support can form part of longer-term gastric management, but supplements do not treat gastric ulcers.

🩺 What is Equine Gastric Ulcer Syndrome?

A horse's stomach is relatively small and is designed around frequent consumption of forage.

Unlike people, horses produce gastric acid continuously. Eating forage encourages chewing and saliva production, while the physical presence of feed within the stomach can also help protect more vulnerable areas from acidic stomach contents.

The stomach has two distinctly different regions.

The squamous region

The upper portion is lined with squamous mucosa.

This region does not have the same protective mechanisms against stomach acid as the glandular portion below it.

Damage here is known as:

Equine Squamous Gastric Disease — ESGD

ESGD is particularly associated with increased exposure of the squamous lining to acidic stomach contents.

The glandular region

The lower portion produces gastric acid but also possesses natural protective mechanisms that help protect its lining.

Disease affecting this region is known as:

Equine Glandular Gastric Disease — EGGD

EGGD is not simply the same disease occurring in a different location. Its causes and management may differ from ESGD, which is one reason that veterinary diagnosis is important.

Why Do Horses Develop Gastric Ulcers?

There is rarely one simple explanation.

Several factors may combine to increase the likelihood of gastric disease.

Long periods without forage

The horse's digestive system is adapted to frequent eating.

Periods without forage reduce chewing and saliva production and leave the stomach relatively empty while gastric acid continues to be produced.

This can be particularly relevant to ESGD.

Exercise

During exercise, pressure within the abdomen can cause acidic stomach contents to move upwards and contact the less-protected squamous portion of the stomach.

The risk tends to increase with the intensity and frequency of exercise.

High-concentrate feeding

Large concentrate meals and diets containing relatively high levels of starch and sugar may contribute to an environment associated with increased risk of gastric ulceration.

Where concentrates are necessary, dividing the daily amount into smaller meals and maintaining adequate forage intake can be beneficial.

Stabling and restricted turnout

Stabling itself does not automatically cause ulcers.

However, changes associated with stabling — including reduced forage access, less movement, social isolation and altered feeding patterns — may contribute to increased risk in some horses.

Travel and competition

Transport, unfamiliar environments, changes in routine, reduced forage intake and competition may all contribute to gastric stress.

Social and environmental stress

Changes in herd structure, separation from companions, frequent changes of yard or routine and other stressors may affect individual horses differently.

Medication

Some medicines, particularly inappropriate or prolonged use of certain non-steroidal anti-inflammatory drugs (NSAIDs), can adversely affect the stomach's protective mechanisms.

Always use medication according to veterinary advice.

👀 What Signs Might an Owner Notice?

One of the difficulties with gastric ulcers is that there is no single sign that confirms their presence.

Possible signs include:

Reduced appetite
Eating slowly or leaving feed
Weight loss or difficulty maintaining condition
Poor performance
Reluctance to work forward
Changes in behaviour or temperament
Increased sensitivity when grooming or girthing
Recurrent mild abdominal discomfort
Dullness or reduced enthusiasm
Changes in attitude towards work

However, these signs can occur with many other health, dental, musculoskeletal, management and behavioural problems.

Some horses with significant gastric ulceration may show surprisingly few obvious signs, while a horse displaying apparent "ulcer behaviour" may have another underlying problem entirely.

Behaviour alone cannot diagnose gastric ulcers.

🔬 How Are Gastric Ulcers Diagnosed?

The definitive way to diagnose gastric ulceration is gastroscopy.

A long flexible endoscope is passed through the horse's nostril, down the oesophagus and into the stomach while the horse is sedated.

This allows the veterinary surgeon to examine the stomach lining directly and determine:

Whether gastric disease is present
Which area of the stomach is affected
The extent and appearance of any lesions
Whether ESGD, EGGD or both are present
How treatment and management should be approached

The horse normally needs to be fasted beforehand so that the stomach can be properly examined.

Your veterinary practice will provide specific preparation instructions.

💊 How Are Gastric Ulcers Treated?

Treatment should be directed by your veterinary surgeon and may vary according to the location and nature of the disease.

Acid-suppressing medication such as omeprazole is commonly used in the treatment of equine gastric ulceration.

Other medication may sometimes be recommended depending upon the type and location of disease.

Treatment should not, however, be considered in isolation.

If the management factors that contributed to gastric disease remain unchanged, problems may persist or recur.

Your veterinary surgeon may therefore recommend a combination of:

Veterinary treatment + feeding changes + management changes + monitoring

A repeat gastroscopy may be recommended to assess healing and determine whether further treatment is required.

🌱 Managing a Horse with Gastric Ulcers

Management should be tailored to the individual horse, but several principles can help support gastric health.

Maximise appropriate forage access

Avoid unnecessarily long periods when the horse has nothing suitable to eat.

For horses requiring controlled calorie intake, this may mean using appropriately selected lower-calorie forage, slow-feeding methods or other strategies rather than simply creating long periods without food.

Encourage frequent eating

The horse's digestive system is designed for frequent consumption of relatively small amounts.

Review concentrate feeding

Where possible:

Keep concentrate meals relatively small.
Divide larger daily quantities between several feeds.
Avoid unnecessarily high-starch diets.
Choose feed according to the horse's workload, body condition and individual requirements.

Consider forage before exercise

Providing suitable forage before exercise may help reduce exposure of the upper stomach to acidic contents.

Maximise turnout where appropriate

Turnout encourages movement, natural feeding behaviour and social interaction.

Reduce avoidable stress

Consider whether changes to routine, travelling, social environment, stabling or training could be contributing to the horse's overall stress.

Make changes gradually

Sudden changes in feed and management can disturb the digestive system.

Introduce changes progressively wherever possible.

[GRAPHIC 2 — The Gastric-Friendly Daily Management Checklist]

Purpose: A highly practical standalone graphic owners could save to their phone, download, share or print for the feed room.

Headline:

SUPPORTING YOUR HORSE'S GASTRIC HEALTH

Use simple illustrated sections:

FORAGE
✓ Provide regular access to suitable forage
✓ Avoid unnecessarily long periods without forage

FEEDING
✓ Keep concentrate meals appropriately sized
✓ Divide larger daily quantities
✓ Avoid unnecessarily high-starch feeding

EXERCISE
✓ Consider suitable forage before exercise
✓ Review workload and recovery

MANAGEMENT
✓ Maximise appropriate turnout
✓ Maintain social contact where possible
✓ Reduce avoidable stress
✓ Make feed and routine changes gradually

MONITOR
✓ Appetite
✓ Weight and condition
✓ Behaviour
✓ Performance
✓ Droppings and general wellbeing

Bottom callout:

Suspect gastric ulcers? Speak to your veterinary surgeon.
Gastroscopy is the definitive method of diagnosis.

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Supporting better-informed horse care

🥣 Feeding and Gastric Health

Nutrition is an important part of gastric management.

The aim is not simply to "neutralise stomach acid". Gastric health depends upon the interaction between feeding frequency, forage intake, stomach contents, exercise and the stomach's own protective mechanisms.

For many horses this means building the diet around appropriate forage and fibre, with concentrate feed selected according to actual nutritional requirements.

Some forage types, including alfalfa, contain naturally higher levels of calcium and protein and may provide additional buffering within the stomach.

Every horse is different, particularly where obesity, laminitis risk, EMS or other dietary considerations are also present. A horse should therefore not simply be given unrestricted high-calorie forage because gastric ulcers are suspected.

⭐ Nutritional Support for Gastric Health

Veterinary treatment is required where gastric ulceration is diagnosed. Supplements are not medicines and do not treat or cure gastric ulcers.

However, appropriate nutritional supplementation can form part of a broader programme designed to support normal gastric and digestive function, particularly alongside improvements in feeding and management.

JCG / FreeStep Gastric Support

⭐ GG GastroFree

Targeted nutritional support for gastric and digestive health.

GG GastroFree can be considered as part of the nutritional management of horses where maintaining a healthy gastric environment and supporting normal digestive function are priorities.

May be particularly relevant for horses:

In regular work
Travelling or competing
Experiencing changes in routine
Spending significant periods stabled
Where gastric health is an ongoing management consideration

[VIEW GG GASTROFREE]

⭐ GGM GastroFree

Gastric and digestive nutritional support where additional management support is appropriate.

GGM GastroFree provides another option within the FreeStep gastric support range and may be selected according to the individual horse and its wider nutritional requirements.

[VIEW GGM GASTROFREE]

Why are these products shown here?

We only highlight FreeStep products on JCG Health Hub condition pages where there is a logical nutritional connection to the condition being discussed.

For EGUS, supplementation should be viewed as supportive nutrition, not as an alternative to diagnosis or veterinary medication.

If your horse has suspected or confirmed gastric ulcers, veterinary advice, appropriate feeding and good management remain the priorities.

🔄 Preventing Recurrence

For some horses, the challenge is not only healing existing gastric disease but reducing the likelihood of it returning.

Once veterinary treatment has finished, review the horse's whole management system.

Ask:

Is forage available frequently enough?
Are there prolonged periods without food?
Is the horse receiving more concentrate than necessary?
Could meals be divided further?
Is forage available around exercise and travel?
Is turnout adequate?
Has workload recently increased?
Is the horse travelling frequently?
Has its social environment changed?
Are there recurring sources of stress?
Is the horse maintaining an appropriate body condition?

Small changes in several areas may be more valuable than relying on one single intervention.

[GRAPHIC 3 — Gastric Ulcers: The Management Circle]

Purpose: A downloadable/printable infographic demonstrating that managing gastric disease requires several elements working together rather than relying solely on medication or supplements.

Centre circle:

GASTRIC HEALTH

Surrounded by six interconnected segments:

1. VETERINARY CARE
Diagnosis • Treatment • Reassessment

2. FORAGE
Frequent access • Appropriate fibre • Avoid long fasting periods

3. FEEDING
Small meals • Appropriate starch • Balanced diet

4. EXERCISE
Workload • Forage before work • Recovery

5. ENVIRONMENT
Turnout • Companionship • Routine

6. NUTRITIONAL SUPPORT
Support normal gastric and digestive function

Footer message:

**There is rarely one solution to gastric ulcers.

Successful long-term management looks at the whole horse.**

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Practical information • Better-informed management

🚨 When Should I Contact My Vet?

Contact your veterinary surgeon if your horse develops unexplained or persistent changes including:

Reduced appetite
Weight loss
Recurrent abdominal discomfort
Significant behavioural changes
Persistent poor performance
Difficulty maintaining condition
Signs suggestive of colic

Any horse showing significant or persistent signs of colic requires prompt veterinary assessment.

Do not assume that unusual behaviour, girth sensitivity or poor performance is caused by gastric ulcers. Other painful or medical conditions may produce similar signs.

The JCG Health Hub Take-Home Message

Gastric ulcers are common, but they are also frequently misunderstood.

EGUS is not one single disease. The squamous and glandular regions of the stomach are different, and identifying which area is affected can influence how the horse is treated and managed.

For owners, the most useful approach is to think beyond ulcers alone and consider the horse's whole daily routine:

Forage • Feeding • Exercise • Turnout • Travel • Stress • Veterinary care • Nutritional support

Where gastric disease is suspected, obtaining veterinary advice and an accurate diagnosis should come first.

Once that has been established, thoughtful feeding, appropriate management and carefully selected nutritional support can all contribute to maintaining the horse's digestive health over the longer term.

Important

The information provided by the JCG Health Hub is intended for general educational purposes and does not replace veterinary diagnosis or treatment.

If you are concerned about your horse's health, seek advice from your veterinary surgeon.