Equine gastric ulcer syndrome affects the majority of performance horses and requires both medical treatment and management change for resolution.
Equine gastric ulcer syndrome represents a significant welfare burden across the performance horse population, driven largely by the mismatch between horse-evolved feeding behaviour and commercial management practices. Horses evolved to trickle-feed continuously; the stomach secretes acid continuously regardless of food presence. Empty-stomach periods allow acid to contact the unprotected squamous mucosa of the upper stomach, causing progressive ulceration. Pain from gastric ulcers manifests as poor performance, resistance to girthing, reduced appetite, and change in behaviour — signals frequently misinterpreted as training problems rather than medical conditions. Treatment with omeprazole reduces acid secretion and allows healing, but without addressing the management causes — restricted forage, stress, limited turnout — recurrence is near-certain on cessation of medication.