Horse Ulcers: What Causes Them and How to Support Healing Naturally
Ulcers are one of the most common—and most overlooked—issues in horses today. From performance horses to backyard companions, gastric ulcers can quietly impact appetite, behavior, weight, and overall well-being.
The problem? Many owners are treating symptoms without addressing what’s actually causing the issue in the first place.
What Causes Ulcers in Horses?
Horses are naturally designed to graze almost constantly. Their stomach produces acid 24/7, whether they are eating or not. In a natural setting, this acid is buffered by a steady intake of forage and saliva.
When that system is disrupted, the stomach lining becomes vulnerable—and ulcers can develop.
Here are the most common causes:
Stress
Travel, training, competition, stall confinement, and inconsistent routines all increase stress levels. Stress has a direct impact on stomach acid production and can weaken the protective lining of the stomach.
High-Grain Diets
Feeds high in starch—especially heavily processed grains—can increase acidity in the stomach and contribute to ulcer formation. When horses are fed large grain meals without adequate forage, acid exposure increases significantly.
Poor Management Conditions
Limited turnout, long periods without food, and inconsistent feeding schedules all contribute to ulcer risk. Horses that go hours without forage are especially vulnerable.
Low-Quality Supplements and Feeds
Not all supplements are created equal. Some contain inflammatory ingredients, unnecessary fillers, or additives that do more harm than good. Overprocessed feeds can also disrupt digestion and contribute to both stomach and hindgut issues.
Signs Your Horse May Have Ulcers
Ulcers don’t always present dramatically. In many cases, the signs are subtle:
- Decreased appetite or picky eating
- Weight loss or difficulty maintaining condition
- Behavioral changes (irritability, sensitivity, girthiness)
- Poor performance
- Dull coat
- Mild, recurring colic symptoms
Because these signs overlap with other issues, ulcers are often missed or mismanaged.
The Problem With Long-Term Omeprazole Use
Products containing omeprazole (commonly used to treat ulcers) can be effective in the short term. However, long-term use comes with drawbacks that many horse owners aren’t aware of.
Research has shown that prolonged use of omeprazole can alter gastric pH beyond natural levels and may interfere with normal digestive processes. Some studies also suggest that long-term acid suppression can impact nutrient absorption and disrupt microbial balance in the gut.
In addition, horses may experience a rebound effect—where acid production increases once the medication is stopped—making ulcers more likely to return if underlying causes are not addressed.
This is why relying solely on medication without changing feeding and management practices often leads to recurring issues.
3 Things You Can Do Instead
- Prioritize Long-Stem Forage Over Processed Alternatives
Feeding consistent, high-quality hay is one of the most effective ways to buffer stomach acid. Long-stem forage encourages chewing, which increases saliva production and helps protect the stomach lining.
While hay cubes can be convenient, they don’t always provide the same level of buffering due to reduced chewing time. Whenever possible, prioritize actual hay over heavily processed forage products.
- Choose Supplements That Support Digestion—Not Fight It
Look for supplements that include digestive-supporting ingredients rather than inflammatory fillers. Ingredients that support gut health, microbial balance, and nutrient absorption will help create a more stable internal environment. Lost with equine supplements? Something tailored might be best instead of shooting in the dark.
Avoid products loaded with unnecessary additives, artificial ingredients, or low-quality fillers that may contribute to irritation rather than healing.
- Feed a Clean, Minimally Processed Diet
Not all grain is created equal. If your horse requires additional calories beyond forage, focus on high-quality, minimally processed feeds with clearly labeled ingredients.
Avoid heavily processed, high-starch feeds and instead choose options that align more closely with the horse’s natural digestive design. The goal is to support the system—not overwhelm it.
“Always look beyond marketing claims and evaluate the ingredient list itself. What’s actually in the feed matters far more than what’s printed on the front of the bag.” – EN
The Bottom Line
Ulcers are not just a medication problem—they’re a management problem.
Stress, feeding practices, and ingredient quality all play a role in whether ulcers develop and whether they truly heal. While short-term treatment may be necessary in some cases, long-term success comes from addressing the root cause.
When you prioritize forage, reduce unnecessary stress, and feed with intention, you give your horse the foundation it needs to heal and stay healthy.
Because real prevention doesn’t come from a tube—
It comes from how you feed and care for your horse every single day.
