In recent years, equine glandular gastric disease (EGGD) has become a significant concern within the equine community. It impacts the health and performance of horses across various disciplines. Understanding the prevalence, risk factors, and management strategies associated with EGGD is crucial for effective diagnosis.

Prevalence and Impact of EGGD

EGGD encompasses gastric lesions specifically affecting the glandular portion of a horse’s stomach, distinct from squamous gastric disease (ESGD). Heidi E. Banse and Frank M. Andrews highlight in their 2019 article that the prevalence of EGGD varies widely across different populations of horses. Studies report prevalences ranging from 25% to 65% in Thoroughbred racehorses, 47% in Standardbred and Thoroughbred mixed populations, and up to 70% in Canadian show jumpers. This variability underscores the complex interplay of breed, management, and exercise intensity in predisposing horses to EGGD.

The impact of EGGD on equine health extends beyond clinical signs, often manifesting as poor performance, weight loss, and behavioural changes. Banse and Andrews stress the link between EGGD and reduced athletic performance, particularly in sport horses and warmbloods. Moreover, the diagnosis of EGGD remains challenging due to nonspecific clinical signs, necessitating endoscopic examination for definitive confirmation. This highlights the need for heightened awareness and proactive management strategies to mitigate the impact of EGGD on equine welfare.

Diagnostic Challenges and Pathophysiology

Accurate diagnosis of EGGD is pivotal for effective management. According to Jessica Vokes, Amy Lovett, and Benjamin Sykes in their 2023 publication, endoscopic examination is the gold standard for diagnosing EGGD lesions within the gastric glandular mucosa. This diagnostic approach is essential given the unreliable nature of clinical signs associated with EGGD, which often overlap with Equine Squamous Gastric Disease (ESGD).

The pathophysiology of EGGD is still not fully understood, with proposed mechanisms including mucosal defence breakdown, stress, inflammation, and potential bacterial involvement. Banse and Andrews suggest that protective factors within the glandular mucosa, such as prostaglandins and the hydrophobic surface, play crucial roles in helping avoid mucosal damage. Interestingly, recent studies challenge the notion that acid injury alone is the primary cause of EGGD, as evidenced by poor responsiveness to standard acid-suppressive treatments like proton pump inhibitors (PPIs). Instead, factors beyond acid exposure, such as stress-induced alterations in prostaglandin production, may contribute significantly to the development and persistence of EGGD.

Management Strategies and Future Directions

Effective management strategies are vital in combating EGGD and enhancing equine gastric health. Vokes, Lovett, and Sykes emphasise the multifactorial nature of EGGD risk, influenced by breed, exercise regimen, and environmental factors. Specific management practices, including open front stabling, hay net feeding, and omeprazole therapy during stress periods, have shown promise in mitigating gastric disease risk.

Future research directions should focus on elucidating the role of stress, inflammation, and bacterial colonisation in EGGD pathogenesis. Furthermore, large-scale epidemiological studies are needed to explore more therapeutic interventions tailored to different equine populations. By advancing our understanding of EGGD prevalence, diagnostic modalities, and underlying pathophysiology, we can optimise equine management practices and safeguard the well-being of our equine companions.

Avoiding EGGD as a Horse Owner

Ongoing research into equine glandular gastric disease sheds light on its complexity and impact on horse health and performance.

As a horse owner, there are a number of ways you can reduce the risk of gastric ulcers in horses. Consistent access to high-quality forage, such as hay or pasture, helps buffer stomach acid and supports healthy digestion, reducing the risk of gastric lesions. Following dietary recommendations for horses with ESGD, like avoiding large grain meals and limiting starch intake, is also recommended.

Beyond nutrition, optimising the horse’s environment and exercise routine should be a top concern. Implementing stress-reducing measures, such as regular turnout and social interaction with other horses, promotes overall well-being and aids in stress management. A stable design should allow for social interaction and natural airflow to contribute to a more relaxed and contented horse.

Information regarding recent research into EGGD used in this post was gathered from the following articles:

Banse HE, Andrews FM. Equine glandular gastric disease: prevalence, impact and management strategies. Vet Med (Auckl). 2019. Available at:

Vokes J, Lovett A, Sykes B. Equine Gastric Ulcer Syndrome: An Update on Current Knowledge. Animals (Basel). 2023. Available at:

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