European College of Equine Internal Medicine Consensus Statement—Equine Gastric Ulcer Syndrome in Adult Horses
Authors: B. Sykes, M. Hewetson, R. Hepburn, N. Luthersson, Y. Tamzali
Journal: Journal of Veterinary Internal Medicine
Summary
# Editorial Summary: European College of Equine Internal Medicine Consensus Statement on Equine Gastric Ulcer Syndrome The blanket term "Equine Gastric Ulcer Syndrome" has long obscured important distinctions between pathologically and aetiologically different conditions affecting the equine stomach, prompting the European College of Equine Internal Medicine to establish clearer diagnostic nomenclature. This consensus statement advocates abandoning the imprecise catch-all terminology in favour of two primary classifications—Equine Squamous Gastric Disease (ESGD) and Equine Glandular Gastric Disease (EGGD)—mirroring the approach human medicine takes with peptic ulcer disease, recognising that conditions with superficially similar presentations may require fundamentally different management strategies. Critically, ESGD is further subdivided into primary disease (occurring in otherwise normal gastrointestinal tracts and representing the more prevalent form) and secondary disease (arising from underlying abnormalities such as pyloric stenosis), whilst EGGD pathophysiology remains incompletely understood and thus resists further sub-categorisation at present. The committee emphasises precise anatomical localisation—identifying whether lesions affect the cardia, fundus, antrum or pylorus—alongside detailed description of gross appearance when reporting clinical and research findings. For equine professionals involved in diagnosis, treatment and performance management, adopting this refined terminology facilitates more targeted therapeutic approaches and prevents inappropriate extrapolation of treatment protocols between fundamentally distinct disease entities.
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Practical Takeaways
- •When diagnosing gastric ulcers, determine whether lesions are in squamous or glandular mucosa—they require different treatment approaches and have different underlying causes
- •Always document the anatomical location of gastric lesions (cardia, fundus, antrum, or pylorus) in your records to enable meaningful comparison of cases and treatment outcomes
- •If you diagnose secondary ESGD, investigate the cause of delayed gastric outflow rather than treating the ulceration in isolation
Key Findings
- •EGUS encompasses both squamous and glandular gastric disease, which have distinct pathophysiology and should not be treated as a single entity
- •Primary ESGD (more common) occurs in horses with normal GI tract, while secondary ESGD results from delayed gastric outflow such as pyloric stenosis
- •EGGD pathophysiology remains poorly understood and cannot yet be subclassified by lesion type
- •Standardized nomenclature distinguishing anatomical location (cardia, fundus, antrum, pylorus) and lesion appearance is essential for consistent clinical and research communication