Equine Glandular Gastric Disease in Horses: Symptoms and Treatment

Quick Answer
  • Equine glandular gastric disease, or EGGD, affects the glandular lining in the lower part of the stomach and is different from squamous ulcers.
  • Common signs include poor performance, attitude changes, girthiness, reduced appetite, mild recurrent colic, and weight or body condition loss.
  • A horse can have vague signs or no obvious signs at all, so diagnosis usually requires gastroscopy performed by your vet.
  • Treatment often combines management changes with prescription medication such as omeprazole, sucralfate, or misoprostol, depending on the case.
  • Many horses improve, but glandular disease can be slower to heal than squamous disease and may need recheck scoping.
Estimated cost: $500–$2,400

What Is Equine Glandular Gastric Disease in Horses?

Equine glandular gastric disease, usually shortened to EGGD, is a form of equine gastric ulcer syndrome that affects the glandular part of the horse's stomach. This is the lower region of the stomach, including areas near the pylorus, where the stomach normally produces acid and protective mucus. In a healthy horse, this lining has defense mechanisms that help it tolerate acid. With EGGD, that protection appears to break down, leading to inflammation, erosions, or ulcers.

EGGD is not the same thing as equine squamous gastric disease (ESGD). Squamous disease affects the upper, non-glandular portion of the stomach and is more directly linked to acid splash during fasting and exercise. Glandular disease is more complex. Current evidence suggests it is tied not only to acid exposure, but also to impaired mucosal defense, stress, management factors, and sometimes medication use such as NSAIDs.

For pet parents, the frustrating part is that signs can be subtle. A horse may seem sour under saddle, lose condition, resent grooming around the girth, or have intermittent mild colic without dramatic digestive signs. Because those signs overlap with many other problems, your vet usually needs to confirm the diagnosis with a gastroscopy rather than symptoms alone.

Symptoms of Equine Glandular Gastric Disease in Horses

  • Poor performance or unwillingness to work
  • Behavior changes such as irritability, resentment of grooming, saddling, or girthing
  • Reduced appetite, picky eating, or slower eating
  • Mild recurrent colic, especially around feeding or work
  • Weight loss or loss of body condition
  • Dull hair coat or decreased overall thriftiness
  • Intermittent loose manure or poor manure quality
  • Bruxism, stretching, or signs of abdominal discomfort
  • No obvious outward signs despite active lesions

Many horses with EGGD do not show dramatic symptoms. Instead, they may have vague changes in attitude, appetite, or performance that build slowly over time. That is one reason this condition is often missed or confused with training, tack, musculoskeletal, or behavioral issues.

See your vet promptly if your horse has repeated mild colic, persistent appetite changes, weight loss, or a clear drop in performance. See your vet immediately for severe colic, repeated rolling, marked depression, inability to eat, or signs of dehydration, because those signs can point to more urgent problems than gastric disease alone.

What Causes Equine Glandular Gastric Disease in Horses?

EGGD is thought to develop when the glandular stomach's normal protective barrier is disrupted. Unlike squamous ulcers, which are strongly linked to acid splash, glandular disease seems to involve failure of mucosal defense. That means the stomach lining may not protect itself well enough from acid, digestive chemicals, inflammation, or reduced blood flow.

Several risk factors have been associated with EGGD. These include intense exercise, frequent training, stall confinement, limited turnout, social stress, frequent changes in routine or handlers, and periods without forage. Some horses also develop gastric disease after NSAID use, especially if dosing is prolonged or not well matched to the horse's overall health status. High-concentrate feeding and lower forage intake may also contribute.

Not every horse with these risk factors develops EGGD, and not every horse with EGGD has an obvious trigger. That is why your vet will usually look at the whole picture: workload, feeding schedule, turnout, stress level, medication history, and whether there may be another painful condition contributing to stress and appetite changes.

How Is Equine Glandular Gastric Disease in Horses Diagnosed?

The only reliable way to diagnose EGGD in a living horse is gastroscopy, also called gastric endoscopy. Your vet passes a long endoscope through the nose into the stomach to directly examine the lining. This allows them to tell whether lesions are in the squamous region, the glandular region, or both. That distinction matters because treatment response can differ.

Before gastroscopy, horses are usually fasted for about 12 to 16 hours, with water often withheld for a shorter period so the stomach can be seen clearly. Sedation is commonly used for the procedure. Your vet may describe the lesions by location, appearance, and severity, especially around the pylorus and antrum where glandular lesions are often found.

Because symptoms are nonspecific, your vet may also recommend other testing to rule out look-alike problems. Depending on the horse, that may include an oral exam, lameness evaluation, bloodwork, fecal testing, ultrasound, or a review of saddle fit, diet, and training schedule. In some cases, a recheck gastroscopy after treatment helps confirm healing and guide next steps.

Treatment Options for Equine Glandular Gastric Disease in Horses

Spectrum of Care means you have options. Here are treatment tiers at different price points.

Budget-Conscious Care

$500–$1,000
Best for: Horses with mild, chronic signs when finances are limited, or when your vet feels a short trial of management-based care is reasonable before scoping.
  • Farm exam and history review
  • Empiric management changes when gastroscopy is not immediately feasible
  • More continuous forage access, reduced fasting time, and turnout adjustments
  • Review of NSAID use, training intensity, travel, and social stressors
  • Targeted medication plan chosen by your vet, often with one prescription rather than combination therapy
Expected outcome: Some horses improve with management changes and medication, but response is less predictable without confirming lesion type and severity.
Consider: Lower upfront cost, but there is a higher chance of treating the wrong problem, missing mixed squamous and glandular disease, or delaying a more precise plan.
Most Common

Recommended Standard Treatment

$1,000–$1,800
Best for: Most horses with suspected gastric disease, especially those with ongoing performance issues, appetite changes, or recurrent mild colic.
  • Gastroscopy to confirm EGGD and identify lesion location
  • Prescription treatment directed by your vet, commonly omeprazole plus sucralfate or another evidence-based protocol
  • Feeding and management changes to reduce stress and support mucosal healing
  • Adjustment of exercise schedule during treatment
  • Follow-up exam and discussion of recurrence prevention
Expected outcome: Good for many horses when diagnosis is confirmed and management factors are addressed, though glandular lesions may heal more slowly than squamous lesions.
Consider: More accurate and usually more efficient than empiric treatment alone, but requires sedation, fasting, and a higher initial cost range.

Advanced / Critical Care

$1,800–$2,400
Best for: Horses with severe lesions, repeat relapse, mixed gastric disease, poor response to initial treatment, or high-value performance demands.
  • Referral-level gastroscopy and repeat recheck gastroscopy
  • Combination prescription therapy such as omeprazole with sucralfate or misoprostol when your vet feels it is appropriate
  • Broader workup for concurrent pain, poor performance, inflammatory disease, or medication-related injury
  • Nutrition consultation and detailed management redesign for high-risk sport horses
  • Closer monitoring for horses with persistent signs, relapse, or poor response to first-line care
Expected outcome: Often favorable when the underlying stressors and concurrent conditions are identified, but some horses need longer treatment and repeated monitoring.
Consider: Most comprehensive approach, but higher cost range and more time commitment. It may also involve off-label medication use that requires careful veterinary oversight.

Cost estimates as of 2026-03. Actual costs vary by location, clinic, and individual case.

Questions to Ask Your Vet About Equine Glandular Gastric Disease in Horses

Bring these questions to your vet appointment to get the most out of your visit.

  1. You can ask your vet whether my horse's signs fit glandular disease, squamous disease, or another problem entirely.
  2. You can ask your vet whether gastroscopy is recommended now, and what fasting and sedation will involve.
  3. You can ask your vet which treatment options make sense for my horse's lesion location, workload, and budget.
  4. You can ask your vet whether omeprazole alone is likely to be enough, or whether sucralfate or misoprostol should be considered.
  5. You can ask your vet what management changes matter most for my horse, such as turnout, forage access, training schedule, and travel routines.
  6. You can ask your vet whether NSAID use, pain elsewhere in the body, or stress could be contributing to recurrence.
  7. You can ask your vet when a recheck gastroscopy would be helpful and what improvement should look like at home.
  8. You can ask your vet what warning signs mean the plan is not working and when to call sooner.

How to Prevent Equine Glandular Gastric Disease in Horses

Prevention focuses on reducing the management and stress factors that can overwhelm the stomach's natural defenses. Horses are designed to eat forage frequently, so one of the most helpful steps is to avoid long periods without hay or pasture access whenever possible. More turnout, more social contact when safe, and fewer abrupt routine changes may also help lower risk.

Work with your vet to review your horse's feeding and training plan. Many horses benefit from more consistent forage intake, careful use of concentrates, and thoughtful scheduling around travel, competition, and hard exercise. If your horse needs NSAIDs, your vet can help balance pain control with stomach protection and monitor for side effects.

If your horse has had EGGD before, recurrence prevention matters. That may include rechecking management practices, using medication strategically during high-stress periods if your vet recommends it, and watching closely for early signs like appetite changes, girthiness, or a drop in performance. Early follow-up often keeps a mild setback from becoming a longer, more costly problem.

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