Gastric ulcers affect a majority of performance horses and many leisure horses. Early diagnosis and appropriate management can prevent chronic pain and significantly improve equine welfare.
Equine gastric ulcer syndrome (EGUS) represents a widespread welfare problem created largely by modern horse management practices. Horses evolved to spend 16-18 hours daily grazing, continuously buffering stomach acid with food and saliva. Stabling, reduced forage access, high-concentrate diets, and intensive exercise create ideal conditions for ulcer formation. Affected horses experience chronic pain that is often underrecognized because horses mask pain well. Welfare assessment should include behavioral changes alongside clinical signs. Treatment with omeprazole is effective but requires consistent management changes to prevent recurrence. Increasing forage access, reducing stabling time, minimizing NSAID use, and providing more frequent small meals dramatically reduce ulcer risk. The veterinary community increasingly recognizes EGUS as a management disease requiring systemic changes.