Gastric ulcers in dressage horses: prevention through feeding and management
Equine gastric ulcer syndrome (EGUS) is now recognised as one of the most common health concerns affecting performance horses, including dressage horses. In this expert guide from D&H, the latest research highlights how feeding practices, training intensity, travel, stress and management routines can all contribute to ulcer risk.
Dr Marga Mas MRCVS – D&H Head of Veterinary, Equine Health & Performance
What is the latest evidence on EGUS?
Equine gastric ulcer syndrome (EGUS) is now recognised as one of the most common health issues affecting performance horses – and dressage horses are no exception. Whether you are competing at affiliated level or training at home, understanding how ulcers develop and how to prevent them is key to supporting your horse’s long-term health and performance. EGUS encompasses two distinct conditions based on which region of the horse’s stomach is affected: equine squamous gastric disease (ESGD) affecting the upper portion of the stomach, and equine glandular gastric disease (EGGD) affecting the bottom portion of the stomach and the outlet into the small intestine. Each of these conditions has different causes, risk factors and prevention strategies (Lensing and Barton, 2025).
Whilst recent research highlights that equine gastric ulcers are multifactorial, meaning no single cause is responsible, it is also recognised that feeding practices, workload, travel, and even environmental conditions all play a role (Sykes et al., 2025):
- Training intensity, competition schedules and changes to routine leading to stress constitute a risk factor for EGGD as they contribute to inflammation and disruption to the natural defence mechanisms of the glandular portion of the stomach (Van den Boom, 2023; Lensing and Barton, 2025).
- Diets low in fibre and high in cereal grain starch contribute to reducing the pH (a measure of acidity) in the horse’s stomach, delay gastric emptying and promote pooling of acid in the stomach, and destabilise the gastric microbial population. Exercise at speeds higher than a trot, particularly if the horse has been fasting for more than 4 hours, greatly increases acid exposure of the squamous mucosa (which naturally does not have protection mechanisms) – all of these factors increasing the risk of ESGD (Sykes et al. 2015; Sykes et al. 2019).
Dressage horses may not gallop at racing speeds, but there are factors which could be high-risk for gastric ulcers – namely pressures from training and competing, lack of continued access to forage or foraging opportunities, and susceptibility to stress.
Feeding dressage horses for gastric health
Once again, it comes down to forage first and prioritising fibre as a core source of energy in the horse’s diet by allowing the horse access to plenty of forage sources throughout the day and night. A key aspect of gastric ulcer prevention, specifically important for ESGD, is to avoid factors contributing to rising acidity in the stomach: fibrous feed intake stimulates the production of saliva which contains bicarbonate and supports a healthy stomach pH and helps create a forage barrier against the spread of acidic gastric fluids to the upper squamous mucosa. Additionally, foraging is a core natural equine behaviour, and creating sufficient foraging opportunities in the daily schedule is a key aspect to support welfare especially in dressage horses that follow a training and competition schedule (Ermers et al. 2023).
To help ensure your horse meets their fibre requirement (which is a minimum of 1.5% of their body weight in daily forage dry matter), focus on foraging opportunities by offering a combination of grass where possible, preserved forages (hay or haylage) and fibrous feeds (chaffs and chopped fibres) – and ensure your horses does not go for more than 4h without access to forage, especially overnight and during travel. Studies show that meeting the daily fibre intake supports a healthy gastrointestinal and immune function, adequate body condition, healthy behaviours and adequate athletic performance.
Balancing performance and weight control
For some dressage horses, daily forage sources will provide enough energy to maintain body condition and sustain their training programme and requirements from travel and competition. Where weight management is as much of a nutritional goal as optimal performance, a high-quality feed balancer provides a concentrated source of essential nutrients, including vitamins, minerals and quality protein, designed to complement a high fibre diet without adding significant calories. Provision of essential amino acids, particularly lysine, is key to support muscle mass turnover and correct neuromuscular function is further supported by adequate intake of micronutrients like vitamin E and selenium which also support recovery from effort.
Fuelling focus and stamina
For dressage horses that require additional energy for conditioning and training, a bucket feed with a correct balance of energy sources can support performance without increasing ulcer risk by reducing reliance on cereal-based ingredients in favour of digestible fibres and quality oils. Current scientific consensus is that nutritional factors are key when it comes to reducing gastric ulcer risk (Bachman et al, 2024; Sykes et al. 2015; Sykes et al. 2025). High-starch diets, especially those with a high inclusion of cereal-based feeds, are less commonly fed to dressage horses than to those of other disciplines, it is important to note that to minimise ulcer risk a horse should not be fed more than 1 gram of starch per kilogram of body weight per single meal (i.e. 500 g of starch per feed for a 500-kg horse). Look for a performance feeds which combines balanced energy sources with a controlled starch level (12% and under) and high-quality sources of protein and micronutrients designed to support focused, collected work.
Five top tips to reduce gastric ulcer risk
- Keep forage in front of your horse at all times through a combination of grass, hay or haylage and fibre-based feeds to buffer stomach acid and mimic natural grazing behaviour.
- Combine a forage-based diet with either a balancer or a feed with balanced energy from fibres and oils and a minimal incorporation of cereal-based ingredients to control starch intake.
- Avoid long periods (> 4-6 hours) without access to forage and feed, particularly overnight or during travel and offer your horse plenty of access to fresh, clean water.
- Feed fibre before you ride: a small hay net or half a scoop of molasses-free chaff or chopped fibre before exercise can help reduce acid splash in the stomach during work.
- Reduce stress where you can: maintain consistent routines, ensure your horse has opportunities to forage and bond with other horses where practical, and consider your horse’s individual response to travel and competition.
And remember, whilst veterinary treatment—most commonly with omeprazole—is effective at supporting the healing and prevention of gastric ulcers, long-term success and especially prevention depends on optimising feeding and management factors individually to each horse.
References
Bachmann, M. et al. (2024) Carbohydrate digestion in the stomach of horses grazed on pasture, fed hay or hay and oats. Journal of Equine Veterinary Science 2024, 141.
Ermers C. et al. (2023) ‘The fibre requirements of horses and the consequences and causes of failure to meet them’. Animals 2023, 13, 1414.
Lensing, R. and Barton, A.K. (2025) ‘Update on diagnosis, nonpharmacological treatment and prevention of Equine Gastric Ulcer Syndrome’. Equine Veterinary Education Vol. 38, pp. 206-219.
Sykes B.W. et al. (2015) ‘ECEIM Consensus Statement – Equine Gastric Ulcer Syndrome in Adult Horses’. Journal of Veterinary Internal Medicine Vol. 29, pp. 1288-1299.
Sykes, B.W. et al. (2025) ‘Workshop report: Dorothy Russell Havemeyer Foundation Meeting on Equine Gastric Ulcer Syndrome: Advances in the field’. Equine Veterinary Journal Vol. 57, pp. 823-826.Top of FormBottom of Form