New data based on health insurance claims paid-out over the last 40 years, indicates the top five most common health problems in horses include gastric ulcers, arthritis, colic, inflamed ligaments and laminitis, in that order, according to Allianz Insurance and Pet Plan Equine.

Stomach ulcers are the primary health epidemic in the equine world and may be preventable. More than 52% of horses of all breeds from 1 to 24 years old had gastric ulcers during a recent gastro-endoscopic study. The Equine Gastric Ulcer Council found that gastric ulcers were present in 80% to 90% of racehorses in training.

Elusive Symptoms of Gastric Equine Ulcers

Most people do not know for sure whether their horses have gastric ulcers. They might only suspect the presence of ulcers because of small noticeable changes in their horse’s condition. For example, adult horses with ulcers can exhibit symptoms that might include a combination of poor appetite, dullness, attitude changes, decreased performance, rough hair coat, weight loss, colic or poor hoof condition.

During a recent swing through the major horse training facilities in Florida, researchers from SBS Equine conducted more than 20 one-on-one interviews with many of the top horse trainers in the country. Although most of the trainers share health information regularly with their competitive neighbors, the feeding program for the horses under their control was, in some cases, considered a trade secret. 

After all, it is a competitive industry, and feed is what fuels the animal. Most of the trainers surveyed admitted to having problems with equine gastric ulcers as being a significant problem. Those who said that they had few or no problems at all, did seem to follow a similar feeding pattern.  

Causes of Gastric Equine Ulcers

Horses in training. A survey of the trainers at the Florida facilities revealed that those who fed their horses four or five small meals a day had far fewer problems with gastric ulcers than those who fed their horses two or three meals a day. The bottom line is concentrate feeding can inadvertently contribute to ulcer formation by its influence on increasing serum gastric levels, lowering the horse’s roughage intake, and reducing the amount of time spent eating. Imposed feed deprivation, such as in colic management cases, can result in erosion and ulceration of the gastric mucosa as well.  

In the case of horses in training, they are often not fed immediately before training or competing, which results in a significant increase in stomach acidity. Also, horses can become excited during training and racing, further lowering gastric pH. These influences contribute to gastric ulceration. Studies show that the higher the degree of training activity, the increasing severity of gastric lesions. 

Transporting horses. It is also common knowledge that horses being transported are under a lot of stress. This event can induce symptoms of gastric ulcers. There are safe and inexpensive natural alternatives to acid-blocking drugs that could be used instead of drugs when transporting horses for short term trips. 

Ulcer Formation Mechanism

Most ulcers occur in the fundic portion of the stomach, which has a phospholipid-rich, protective epithelial layer. Disruption of this barrier (mucous, surface-active phospholipids) is initial to the destruction of the stomach’s surface epithelium. Because most domesticated horses do not regularly feed like nature designed them to, excess acid can ulcerate this protective layer. Unless the mucous lining is strong enough to withstand the powerful acids produced here, ulcers often develop.

Management of Equine Gastric Ulcers

There are various therapeutic protocols used for the control of equine gastric ulcers. These include antacids (think of products such as Tums and Rolaids) and H2 acid blockers such as the pharmaceutical products Pepcid and Prilosec. These treatments will reduce acid in the fundic portion of the stomach and will reduce the occurrence of ulcers, but there might be unintended negative consequences from these treatments. 

Stomach acid is an essential component of the initial stage of the digestive process. In this initial stage of digestion, if there is not adequate acid present to break down food, it will pass into the small intestine only partially digested. The nutrients won’t be in a form that can be absorbed in the small intestine, and the horse will not get adequately nourished.  

There is a better way to protect the horse from and treat gastric ulcers. When the horse is given a nutritional supplement of mixed-phospholipids and apple pectin added to its regular diet, the acid in the fundic portion of the stomach immediately breaks it down into a mix of reactive phospholipids. These phospholipids are both hydrophilic and hydrophobic and interact with the cell membranes of the mucosal epithelium to strengthen the mucosa. 

Research has shown that these ingredients not only treat the symptoms of equine ulcers, but they also cure the ulcers as well by making the stomach lining stronger at the cellular membrane level. The beneficial effects of a diet supplemented with the mixed-phospholipids and apple pectin enhance the rest of the digestive tract as well. There has been much research to substantiate this. Horses that have ½- to 1-cup of this food additive added to their feed ration daily has shown to reduced levels of excitability and anxiety.


The presence of gastric ulcers in horses is associated with poor body and hoof condition, irritability, and poor performance. Treatment options such as reducing stomach acid production with the aid of acid-blocking drugs are expensive. They can disrupt the normal digestive process by not allowing the food to begin its initial breakdown as nature intended. 

A less costly and more effective treatment for horses is to add mixed-phospholipids containing apple pectins to the daily food ration. The phospholipids strengthen the epithelial lining of the stomach, treating and preventing gastric ulcers and allow for the proper absorption of nutrients in the small intestine. The apple pectins help to buffer the stomach lining and slow the digestive process. Pectins also are prebiotic in that they support beneficial microflora in the gastrointestinal tract.

Horses with stomach ulcers can successfully wean off of expensive acid-blocking drugs with the help of these nutrients, which strengthen the cell membranes during the 30-day time period that acid-blocking drugs are often prescribed. Long-term use of phospholipid/pectin supplementation taken for maintenance in the recommended dosage has shown to be effective in preventing the reoccurrence of stomach ulcers.

For convenience, premixed commercial feed supplements containing all of the recommended vital nutrients for treating gastric ulcers are now available in palatable granular form for horses.

For more articles on equine gastric ulcers and other horse related issues, visit SBS Equine.