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  • Francesca Hennessy

Equine ulcers – the hidden effect of domestication

Updated: Apr 29, 2018

In their natural habitat, horses would be eating grass and herbage for over 16 hours a day; fast forward to studs and liveries and their necessary stabling routines and lifestyle stressors and we see equine ulcers forming. I thought I'd share some information on why ulcers happen, how to prevent them in the first place and what you can do once they are suspected.

According to Succeed (, gastric (stomach) ulcers affect 87% of performance horses and 55% of leisure horses; equate this to 1 in 3 horses that will suffer. Gastritis and ulcers are one of the most common conditions I am called to treat as an equine healer, especially as stress is a major factor.

One in three horses will suffer from ulcers

Equine Gastric Ulcer Syndrome (EGUS) has become the accepted parent term to describe gastric ulceration of the stomach as a symptom of a more specific underlying condition. This is by far the most common disease condition that will affect the stomach of a horse. The syndrome covers a wide spectrum of severity from an inflamed but intact stomach lining through to widespread erosion and bleeding.

Gastric lesions form when aggressive factors in gastric juice – eg acid and digestive enzymes – overpower the protective factors in the stomach lining; ie when there is an imbalance between factors that cause erosion of the lining and factors that protect it.

Which horses are most prone to gastric ulcers?

Any horse can be affected but primarily ulcers are seen in performance horses and racehorses and foals are also at particular risk:

  • 37% of leisure horses

  • 63% of performance horses93% of racehorses

  • 50% of foals in the first few months of life.

What causes ulcers?

In one word, #stress. Stress to the stomach (feeding routines and competitive exercise) and lifestyle/emotional causes of stress.

Diet and feeding schedule: A high-concentrate, low-roughage diet and infrequent feeding increase the risk of gastric erosion; a horse is naturally a trickle feeder, with the stomach designed to expect a constant supply of food with a continuous secretion of acid. If a horse is fed only twice a day and denied free access to grass or hay (or fail to eat due to illness) there are prolonged periods when the stomach is empty. Over stabling in yards can be a real contributor to acid erosion.

Exercise intensity (performance horses): A study by Orsini and Hackett showed that the amount and severity of squamous disease increased with the duration and intensity of training. A 2002 study also demonstrated that during exercise, the horse’s stomach is compressed, forcing acidic contents upwards, inducing acid injury to the sensitive squamous mucosa. Horses are not designed to be put under the intense physical pressure require by competition.

Physical and emotional stress: Stressful lifestyle conditions can also adversely effect feed intake which can result in periods of increased stomach acidity – changes in routine or excessive travel, changes in yard, loss of companion or environmental pollution can add to the risk factors. This is where #equinehealing can really be effective as it works on the parasympathetic nervous system, allowing the horse to release stress and promote an overall sense of security and well-being..

Illness and medication: Some long-term medications can produce adverse gastric effects as they may inhibit production of the substances the body used to protect the stomach, eg NSAIDs , aspirin and anaesthesia.

What are the symptoms of ulcers?

General symptoms of EGUS can be difficult to recognise and often it is the guardian's instincts that flag it as a possibility. Symptoms may include:

  • Lack of/poor appetite

  • Difficulty maintaining weight/weight loss

  • Recurrent colic

  • Changes in hair/coat (dull)

  • Changes in behaviour

  • Changes in performance

  • Foals can show teeth grinding, excess salivation and excessive lying down

  • Wind sucking.

Pain on girthing and flank sensitivity used to be attributed to EGUS but, because of the location of the stomach to saddle and girth, its normally more likely to be a hind gut disorder.

Preventative treatment for gastric ulcers – free access and reduce stress

You can help reduce the potential for gastric ulcers in your horse by trying to mimic natural conditions as closely as possible:

  • Allow free-choice access to grass or hay.

  • Fee hard feeds/concentrates more frequently – no less than 6 hours apart.

  • Cut down on high carbohydrate diets – high starch feeds are associated with increased acid production.

  • Use textured rather than pelleted food: A recent study at Texas University found that horses fed a diet consisting of grass hay and a textured feed had lower ulcer scores than those fed hay and pelleted feed (textured feeds = unground grains).

  • Slow down hay consumption by splitting hay into several small hay nets, double netting or using a #Pacefeeder Box (

  • Allow access in the stable or visibility of companion horses (or a mirror so they don’t feel alone).

  • Give free access to a good water supply in the field and stable – water dilutes the gastric fluid.

  • Avoid confinement and provide adequate turnout time to combat stress and boredom.

Complimentary treatments for ulcers

Healing: #equinehealing helps by alleviating the symptoms of ulcers (pain, inflammation) and will also affect the horse’s overall health and state of mind. If the ulcers are being caused by a stressful lifestyle, healing reduces the amount of stress being experienced and promotes total wellbeing. As the stomach sits within the region of the solar plexus,I would be looking for issues of power (is the equine accepted in his herd; how is the relationship between equine and owner; adrenaline levels after competition or due to fear?).

Bach Flower remedies: Rescue Remedy, Vine, Agrimony, Larch and Walnut.

Herbs/essential oils: #Peppermintoil is excellent for gastric issues and can be used direct on the skin to rub the belly button area to calm the discomfort and encourage peristalsis. A qualified #zoopharmacognicist or equine herbalist will be able to offer herbs as part of a treatment or prevention plan. These might include:

Peppermint: A must have for colic-prone horses as it helps to normalise digestion. It can also alleviate stress and nervousness.

Aloe vera juice: Aids in repairing the stomach lining, soothing the stomach and digestive tract (I’ve found this very useful for my own acid-related stomach issues). The Forever Living brand is very pure.

Slippery elm or marshmallow: An anti-inflammatory herb that reduces irritation and promotes healing in the stomach – often mixed with aloe vera juice (2 ounces of AVJ with 2tsp of slipper elm bark powder can be administered with a syringe 3 x daily before meals).

Licorice: An anti-ulcer herb that reduces inflammation in the stomach but should not be used long-term as it can lower gastric secretions.

Chamomile: Acts as a parasympathetic nervous system relaxant and can be made up as a tea and cooled as a drink to help alleviate stress responses or used with the aloe vera and slippery elm mix.

Dried cabbage: Cabbage is full of the amino acid L-Glutamine, which has been proven to heal the stomach lining.

Raw pumpkin seeds (peeled/hulled): Pumpkin seeds are high in Nitric Oxide which the body uses to heal.

Papaya: Papayas contain digestive enzymes that digest proteins by breaking down the protein content and fibrin which acts as healing reagent for external and internal wounds.

Chia seeds: If you soak seeds in water they produce a gel-like substance found in most plants called mucilage. Mucilage helps soothe the pain and inflammation associated with gastric ulcers by forming a protective barrier on the mucosal surface (Borelli and Izzo, 2000).

NB The herbal information included here is for informative purposes only. If your horse is receiving veterinary medication, please notify your vet before administering herbs and a qualified herbalist should always be sought before offering herbage to your horse.


Suggested two-week ulcer healing diet from

Fed twice a day in a bucket:

1 pound soaked shredded beet pulp

2 cups of soaked alfalfa pellets (high protein)

1 cup of Rice Bran (good fiber source, great fat source, full of Vitamin E which is great for immune system)

1/2 cup ground Flax seeds (omega 3 fatty acids in the diet are helpful in reducing inflammation in the tissues of horses and potentially assist in the strengthening of a weak immune system.

1/4 cup chia seeds

1/4 cup dried cabbage (L-Glutamine heals the stomach),

1/4 cup papaya (active enzyme fibrin is healing)

1/4 cup Aloe Vera juice

Licorice- we used a herbal extract in alcohol form of the herb and gave 10 to 15 cc for the first 10 days.

1 oz. Fast Track Probiotics (aids digestion)

Free choice of hay in a slow feeder net and daily turn out with grass.

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