Looking after your horse’s gut

How much do we think about our horse’s gut health? Probably not much until there is a problem. Vet Kate Brickman MRCVS explains what we need to know and how to guard against some common gut issues.

Gastric ulcers in horses can not only cause physiological changes, but behavioural changes too. Understanding how to manage gastric ulcers needs to start with understanding the horse’s stomach, the different types of ulcers and their signs and symptoms. Vet Kate Brickman MRCVS explains what we need to know and how to guard against them and we look at some of the products on the market manufactured with gastric ulcers in mind. 


  • The equine stomach is made up of the squamous region (the top third of the stomach, which is white in colour) and the glandular region (the pink lower region). These two areas are separated by a line known as the Margo Plicatus.
  • The cardia is the entry of the oesophagus into the stomach and the pylorus is the exit of the stomach into the duodenum. 


  • There are two types of gastric ulcers: primary squamous disease (these ulcers affect the top third of the stomach) and glandular disease (these ulcers usually form around the pylorus).


  • Typically gastric ulcers are associated with weight loss, poor coat condition and being unsettled in the stable. 
  • Symptoms might be anything from very subtle behavioural changes, such as not being as responsive to leg aids, not extending their stride as much when asked, rushing out of the stable when tacked up and being ‘cold backed’ when first mounted, to violently trying to bite when girthing up.
  • The only definitive way to diagnose gastric ulcers is to perform a gastroscopy. This involves passing a four-metre long scope with a camera on the end down the horse’s oesophagus and into the stomach to examine all regions. The horse needs to be starved for 12 hours beforehand to allow the majority of food material to be removed from the stomach and the fluid level to go down.



  • Feeding a large amount of fibre, such as hay/ haylage/alfalfa is hugely beneficial for horses with ulcers – adding alfalfa to hard feed increases chewing time, which produces more saliva to buffer the acid in the stomach.
  • Feeding a handful of alfalfa chaff before exercise is a good way of stopping the acid splash that often causes squamous ulcers. 
  • Make sure the horse has access to forage at all times to keep the stomach full, even if this means supplementing grass with hay or haylage when the horse is turned out in winter. 
  • Feed sugar beet as it contains Pectin which protects the glandular region of the stomach, additional yeast which aids fibre digestion and provides B vitamins, and protein and corn oil which is high in omega 3 that also protects the glandular region of the stomach and provides energy in a less inflammatory form than starch. 
  • British Horse Feeds Products’ Speedi-Beet and Fibre-Beet have both recently been awarded with the British Equestrian Trade Association (BETA) Assurance Mark for products suitable for horses prone to equine gastric ulcer syndrome (EGUS). Speedi-Beet and Fibre-Beet are both low in starch and sugar, high in fibre and are particularly rich in those glandular-region-protecting Pectins and have high acid binding capacity which means they can soak up excess stomach acid.
  • Saracen Horse Feeds are also celebrating a double BETA Assurance Mark for products suitable for horses prone to EGUS; the cereal free mix RE-LEVE® and the recently launched Competition-Fit Balancer. Both formulated to support healthy digestion and gastric health, the nutrient dense, low in starch Competition-Fit Balancer is a balancer that has all the right levels of live yeast and Acid-Buf that has been proven to maintain an optimum environment in the stomach and digestive tract.  


  • Squamous ulcers can only be treated with Omeprazole (Gastroguard or Peptizol), which decreases the acidity of the stomach. 
  • Pyloric ulcers are harder to treat due to their position at the bottom of the stomach meaning the pylorus is constantly bathed in acid. They can be treated with a combination of Omeprazole and Sucralfate (Antepsin), which forms a protective barrier over the lining of the stomach preventing further damage, relieving pain and allowing the area to repair.