High intake of sugars and starch, low number of meals and low roughage intake are associated with Equine Gastric Ulcer Syndrome in a Belgian cohort

J Anim Physiol Anim Nutr (Berl). 2021 Nov:105 Suppl 2:18-23. doi: 10.1111/jpn.13215. Epub 2019 Oct 22.


Equine gastric ulcer syndrome (EGUS) is a pathological condition affecting the glandular and squamous regions of the stomach. It is characterized by non-specific clinical signs, behavioural changes or can also be found without any overt clinical manifestations. Nutritional factors such as intermittent feeding, high sugars and starch intake, large amounts of straw as forage and prolonged time without access to forage have all been associated with an increased risk of equine squamous gastric disease (ESGD). The aim of this study was to investigate which nutritional practices are commonly seen in clinical ESGD cases in Belgium. Medical records of 27 horses referred to the equine nutritional service at Ghent University (2013-2018) due to equine gastric ulcer lesions were reviewed. Twenty-one healthy horses referred for dietary evaluation during the same period were selected as control cases (CC). Dietary evaluation was performed on an individual basis. Forage/concentrate ratio on dry matter basis, forage content in the diet, total dietary sugars and starch intake per day and per meal were analysed. Retrospective descriptive and statistical analyses were performed. Significantly, higher amounts of forage intake (%DM per BW) in the CC vs. ESGD group were noted (p ≤ .05) with average values of 1.39 (SD ± 0.27) and 1.27 (SD ± 0.70) respectively. There were no significant differences for sugars and starch intake in g/kg BW/day (p = .18). However, the sugars and starch intake per meal (g/kg BW/meal) in the CC group (average value 1.06, SD ± 0.56) was significantly (p < .001) lower than in the EGUS group (average value 1.85 SD ± 0.78). Forage intake below the recommended absolute minimum value as well as high sugars and starch intake were most commonly associated with EGUS in the present case series. An adequate diet formulation taking into account these main nutritional factors is therefore essential to avoid gastric problems in horses.

Keywords: horses; nutrition.

MeSH terms

  • Animals
  • Belgium / epidemiology
  • Dietary Fiber
  • Horses
  • Meals
  • Retrospective Studies
  • Starch
  • Stomach Ulcer* / epidemiology
  • Stomach Ulcer* / etiology
  • Stomach Ulcer* / veterinary
  • Sugars


  • Dietary Fiber
  • Sugars
  • Starch