Executive Summary
Equine Gastric Ulcer Syndrome (EGUS), also referred to as equine ulcer syndrome or equine ulcer disease, is among the most prevalent causes of chronic digestive discomfort in modern horses (Sykes et al., 2015). Gastric ulcers in horses—including squamous ulcers, glandular ulcers, ESGD, and EGGD—are frequently recurrent when management focuses solely on acid suppression rather than equine nutrition and feeding management (Andrews et al., 2005).
Introduction
Many ulcer-prone horses never present with obvious colic or weight loss. Instead, early signs of ulcers in horses include intermittent appetite, gastric irritation, girth sensitivity, behavioral resistance, and inconsistent performance—often misattributed to training or temperament (Luthersson et al., 2009). Despite repeated treatment, stomach ulcers in horses frequently return, revealing that feeding strategies—not medication alone—drive long-term outcomes (Sykes et al., 2015).
Understanding EGUS From a Nutritional Perspective
Equine gastric ulcer syndrome includes both squamous ulcers (ESGD) and glandular ulcers (EGGD). Squamous disease is most strongly associated with acid splash horses experience during fasting and exercise, while glandular ulcers reflect impaired gastric mucosa support, stress, inflammation, and altered blood flow (Andrews et al., 2005; Sykes et al., 2015).
Feeding Frequency: Why Timing Matters for EGUS Prevention
Feeding frequency is one of the most impactful but overlooked aspects of ulcer prevention in horses. Large concentrate meals followed by fasting periods longer than six hours significantly increase ulcer risk by prolonging unbuffered acid exposure (Luthersson et al., 2009).
Forage Choice: The Foundation of an Ulcer-Safe Diet
Forage remains the cornerstone of any ulcer-safe feeding plan. Long-stem hay stimulates saliva production, providing natural digestive buffering support and mucosal protection support (Murray, 2013). Forage also creates a physical raft within the stomach, reducing acid splash and gastric erosion during movement (Nadeau et al., 2000).
Alfalfa and Gastric Health
Research confirms that alfalfa and gastric ulcers are linked through buffering capacity. Alfalfa increases gastric pH and reduces squamous ulcer severity compared with some grass hays (Nadeau et al., 2000). Feeding alfalfa before riding to prevent ulcers is particularly effective, though alfalfa vs grass hay decisions should consider mineral balance and overall diet optimization for gastric health (Andrews et al., 2005).
Low-Starch Feeding: Protecting the Stomach and Hindgut
High-starch feeding remains a major contributor to equine ulcers. Grain and ulcers in horses are linked through reduced chewing, rapid gastric emptying, and disrupted hindgut fermentation (Murray, 2013).
Feeding Before Exercise: Acid Splash Prevention
Providing forage 30–60 minutes before work is widely recognized as best practice for how to keep a horse ulcer-free through nutrition, improving gastric mucosa support and reducing exercise-associated ulcer formation (Andrews et al., 2005). This approach is essential for performance horses and during show season feeding plans for ulcer prevention.
Digestive Supplements: Support, Not Substitution
Digestive supplements for horses—including probiotics for horses, prebiotics for horses, yeast culture for horses, omega-3 for horses gut health, glutamine for horses gut, pectin lecithin horses, and other gut soothers for horses—may enhance digestive buffering and fermentation support (Whitfield-Cargile et al., 2022).
Frequently Asked Questions (FAQs)
Q1: What is the best diet to prevent EGUS in horses?
A: A forage-first, low-starch, high-fiber diet with continuous forage access and frequent meals is most effective (Murray, 2013).
Q2: Does grain contribute to gastric ulcers in horses?
A: Yes. Excessive starch intake increases acid exposure and disrupts hindgut fermentation, raising ulcer risk (Nadeau et al., 2000).
Q3: What feeding schedule helps keep a horse ulcer-free?
A: Near-continuous forage access, overnight hay availability, and feeding before exercise are key strategies (Sykes et al., 2015).
Call-to-Action
Assess your current horse feeding strategies for fasting gaps, starch overload, and timing errors. Implement forage-first feeding, refine feeding frequency, and consult your veterinarian or equine nutritionist when needed. Explore additional EGUS prevention resources to further support long-term gastric and digestive health.
References
- Andrews, F. M., Reinemeyer, C. R., & McCracken, M. D. (2005). Equine gastric ulcer syndrome: Pathophysiology, diagnosis, and treatment. Journal of Veterinary Internal Medicine, 19(1), 95–113.
- Luthersson, N., Nielsen, K. H., Harris, P., & Parkin, T. D. (2009). The prevalence and anatomical distribution of equine gastric ulceration syndrome. Equine Veterinary Journal, 41(8), 784–789.
- Murray, M. J. (2013). Equine gastric ulcer syndrome: A review. Equine Veterinary Education, 25(9), 475–484.
- Nadeau, J. A., Andrews, F. M., Mathew, A. G., Argenzio, R. A., & Saxton, A. M. (2000). Evaluation of diet as a cause of gastric ulcers in horses. American Journal of Veterinary Research, 61(7), 784–790.
- National Research Council. (2007). Nutrient Requirements of Horses (6th ed.). National Academies Press.
- Stewart, A. S., et al. (2017). Gastrointestinal permeability and systemic inflammation in horses. Equine Veterinary Journal, 49(2), 229–234.
- Sykes, B. W., Hewetson, M., Hepburn, R. J., Luthersson, N., & Tamzali, Y. (2015). European College of Equine Internal Medicine consensus statement on equine gastric ulcer syndrome. Journal of Veterinary Internal Medicine, 29(5), 1288–1299.
