Clinical Research Abstracts of the British Equine Veterinary Association Congress 2015.
Authors: Crumpton S M, Baiker K, Hallowell G D, Habershon-Butcher J L, Bowen I M
Journal: Equine veterinary journal
Summary
# Editorial Summary: Endoscopic Biopsies and Equine Gastric Glandular Disease Equine gastric glandular disease (EGGD) remains poorly understood despite its prevalence, and endoscopic mucosal biopsies have been proposed as a diagnostic tool to guide treatment decisions. Researchers examined tissue samples from 21 horses at slaughter using three different endoscopic biopsy techniques (two single-bite and one double-bite approach) and compared findings with full-thickness samples to establish diagnostic validity. The double-bite technique (2.4 mm) proved superior, consistently capturing glandular tissue (100% of samples) with minimal artefact, whilst smaller single-bite samples were frequently inadequate for assessment and showed more tissue damage. Crucially, histological findings revealed inflammation rather than ulceration in EGGD cases, with poor correlation between the visual severity of gastric lesions and the inflammatory grade observed microscopically—horses with apparently normal glandular appearance often showed mild gastritis, whilst severe inflammation was detected in horses with minimal visual pathology. These findings have significant implications for clinical practice: endoscopic mucosal biopsies offer limited diagnostic value in predicting underlying disease severity or guiding individualised therapy, since lesion appearance is a poor indicator of the actual inflammatory state. Rather than pursuing routine biopsy sampling, practitioners may benefit from understanding that EGGD represents an inflammatory rather than purely ulcerative process, potentially warranting broader therapeutic consideration beyond acid suppression alone.
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Practical Takeaways
- •Endoscopic appearance alone is unreliable for assessing gastric glandular disease severity; histological examination may be needed for accurate diagnosis
- •If pursuing mucosal biopsies for EGGD, use the double-bite 2.4 mm technique for superior tissue quality and complete gland visualization, though diagnostic yield remains limited
- •Current evidence suggests mucosal biopsies should not be used to guide therapeutic decisions in EGGD, as they demonstrate poor correlation with clinical findings
Key Findings
- •Mucosal biopsies using double-bite technique (2.4 mm) were superior to single-bite techniques, capturing glands in 100% of samples versus 50-66%
- •Horses with normal glandular appearance (grade 0) predominantly showed mild gastritis (71%), indicating poor correlation between endoscopic appearance and histological findings
- •EGGD is characterized by inflammation rather than ulcerative pathology, with no histological evidence of ulceration or erosion identified
- •Mucosal biopsies showed poor reproducibility across sampling techniques (ICC <0.29) and offer limited diagnostic value in predicting underlying disease severity