Comparison of aloe vera and omeprazole in the treatment of equine gastric ulcer syndrome.

Summary

# Editorial Summary: Aloe Vera versus Omeprazole for Equine Gastric Ulceration Despite widespread anecdotal use of aloe vera in equine practice, Bush and colleagues conducted the first rigorous clinical trial to evaluate whether this botanical remedy could match omeprazole's established efficacy in treating equine gastric ulcer syndrome. Their randomised, blinded trial assigned 40 horses with grade ≥2 squamous and/or glandular ulceration to receive either aloe vera inner leaf gel (17.6 mg/kg twice daily) or omeprazole (4 mg/kg once daily) for 28 days, with gastroscopic re-examination to assess healing. For the 38 horses with equine squamous gastric disease, omeprazole proved substantially superior, achieving 75% healing versus only 17% in the aloe vera group (with improvement rates of 85% and 56%, respectively), and horses with delayed gastric emptying showed particularly poor healing prospects regardless of treatment. The non-inferiority hypothesis for aloe vera was not supported, and whilst the limited sample size (n = 14) precluded robust analysis of equine glandular gastric disease, the findings provide no evidence base for replacing proton pump inhibitors with aloe vera monotherapy in clinical practice. Farriers and allied practitioners should be aware that currently available evidence does not support aloe vera as a primary treatment option, though the authors acknowledge the absence of a placebo control limits any definitive conclusions about aloe vera's biological activity.

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Key Findings

• •In ESGD, omeprazole achieved 75% healing rate compared to 17% with aloe vera after 28 days of treatment
• •Omeprazole showed 85% improvement rate in ESGD versus 56% with aloe vera
• •Aloe vera was inferior to omeprazole for treating equine gastric ulceration
• •Prolonged gastric emptying was associated with reduced healing likelihood regardless of treatment

Conditions Studied

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