Equine Gastric Ulcer Syndrome: An Update on Current Knowledge.
Authors: Vokes Jessica, Lovett Amy, Sykes Benjamin
Journal: Animals : an open access journal from MDPI
Summary
# Equine Gastric Ulcer Syndrome: An Update on Current Knowledge Equine gastric ulceration encompasses two distinct pathological entities—Equine Squamous Gastric Disease (ESGD) and Equine Glandular Gastric Disease (EGGD)—which have been collectively termed EGUS since 1999, though the clinical and mechanistic differences between them remained poorly characterised until the European College of Equine Internal Medicine's 2015 consensus statement formalised their definitions and highlighted critical evidence gaps, particularly regarding EGGD. This 2023 review by Vokes, Lovett and Sykes synthesises the substantial body of research published since 2015, with particular emphasis on emerging understanding of EGGD pathophysiology, diagnostic approaches, and therapeutic options that have expanded considerably in recent years. The distinction between these two conditions is now recognised as clinically significant: squamous disease results primarily from acid exposure and feed management factors, whilst glandular disease involves mucosal barrier dysfunction in the non-glandular region, requiring different diagnostic protocols and potentially differing treatment strategies. For practitioners, this updated synthesis is essential reading because diagnostic accuracy and disease classification directly influence management decisions—including feed type, medication selection, and prognosis—and the expanded evidence base now supports more targeted interventions than a one-size-fits-all approach to gastric ulceration. Understanding the current evidence on prevalence, risk factors, endoscopic appearance, and response to omeprazole and other treatments in each disease entity will refine clinical decision-making and improve outcomes across equine medicine and performance management.
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Practical Takeaways
- •Recognize that gastric ulcers in horses fall into two distinct categories (squamous vs. glandular) requiring different diagnostic and treatment approaches
- •Stay updated on EGGD management as recent research has significantly expanded evidence and treatment options beyond earlier limited knowledge
- •Apply current consensus definitions from ECEIM when diagnosing and classifying gastric disease to ensure appropriate clinical management
Key Findings
- •EGUS encompasses two distinct disease entities: ESGD and EGGD, formally defined by ECEIM in 2015
- •Significant knowledge gaps existed for EGGD compared to ESGD, prompting substantial subsequent research
- •Recent studies have substantially advanced understanding of EGGD pathophysiology, diagnosis, and treatment options
- •Current knowledge of both ESGD and EGGD has evolved considerably since the previous large-scale review