Equine gastric ulcer syndrome (EGUS). Prevalence, etiology, diagnostic
Authors: Stefanyk O., Slivinska L.
Journal: Scientific Messenger of LNU of Veterinary Medicine and Biotechnologies
Summary
# Equine Gastric Ulcer Syndrome: Prevalence, Aetiology and Diagnosis Equine gastric ulcer syndrome (EGUS) encompasses ulceration across multiple gastric and duodenal sites and represents a substantial clinical problem, particularly in performance horses where prevalence ranges from 60–90% depending on workload intensity—with intensively trained racehorses approaching the upper threshold and pleasure horses in work averaging around 60%. Stefanyk and Slivinska's literature review synthesises current understanding of gastric pathophysiology, including acid secretion mechanisms and mucosal defence, alongside emerging aetiological factors such as *Helicobacter equorum*, dietary management, dental pathology, anatomical conformation, and nonsteroidal anti-inflammatory drug use, though the definitive role of *Helicobacter* species in equine ulceration remains contentious. Clinical manifestations prove inconsistently observable but may include recurrent or acute colic, poor body condition and appetite, performance deterioration, behavioural changes, weight loss, and occasionally diarrhoea, with consequences extending to impaired foal growth and development. Whilst physical examination, case history and risk factor identification support clinical suspicion, gastroscopy remains the sole definitive diagnostic method, enabling early-stage lesion detection and standardised severity grading via the 0–5 ulcer scoring system. For practitioners, this reinforces that EGUS warrants proactive screening in working horses presenting with non-specific poor performance or digestive signs, and that multifactorial management addressing nutrition, training load, dentition and medication exposure offers the most rational preventative approach.
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Practical Takeaways
- •Screen racehorses and actively trained horses proactively for EGUS given the 60-90% prevalence, even when clinical signs are absent or vague
- •Consider multiple risk factors in prevention: diet/feeding management, dental health, NSAID use, and training intensity — not a single cause
- •Use gastroscopy as the gold standard for definitive diagnosis rather than relying on clinical signs alone, as presentation is often subtle or non-specific
Key Findings
- •EGUS prevalence ranges from 60-90% in horses, with racehorses in active training showing approximately 90% prevalence compared to pleasure horses at 60%
- •Multiple etiological factors identified including Helicobacter equorum, nutritional/dietary management, dental problems, and NSAIDs, though Helicobacter relationship remains controversial
- •Clinical signs are often not noticeable but include colic, poor body condition, anorexia, poor performance, diarrhea, and weight loss when present
- •Gastroscopy is the only definitive diagnostic method currently available; a 0-5 ulcer scoring system is presented for lesion prevalence determination