Significant differences exist between ulcers in the squamous portion of the stomach vs. those located in the glandular portion of the stomach. The glandular portion of the stomach of the horse is exposed to the highly acidic (pH around 3) contents of the stomach, and ulcers are believed to occur due to a breakdown of normal protective mechanisms. The role of bacteria in Equine Glandular Gastric Ulcer Syndrome (EGGUS) is controversial, and some researchers feel the use of antimicrobials to treat EGGUS is not necessary. The use of Nonsteroidal Anti-Inflammatory (NSAID) drugs such as phenylbutazone (Bute) or flunixin (Banamine) as a cause of EGGUS is also somewhat controversial. While high doses of NSAIDS may play a part in some horses, the use of NSAIDS at recommended doses does not explain the high prevalence of glandular ulcers seen in some populations of horses.
The prevalence of glandular ulcers has been looked at in several populations of horses and does not seem to increase as the intensity of exercise increases (as seen with ESGUS). To date, the risk factors for EGGUS have not been well described, but results of several studies suggest that diet (high concentrate/low roughage) may play a role in increasing risk.
Specific treatment regimens for EGGUS have not been well defined. It has been reported that omeprazole alone does not heal glandular ulcers with the same success seen with squamous ulcers. For example, one study reported only a 25% healing rate for glandular ulcers vs. a reported 78% for squamous ulcers. The use of additional therapies, like sucralfate and corn oil, appear to be beneficial in treating glandular ulcers. One study looked at the use of a pectin-lecithin, antacid, and live yeast combination product that showed some promise for helping to prevent glandular ulcers.
Finally, prevention of EGGUS is difficult to outline as risk factors have not been well identified, and the rate of recurrence following treatment has not been reported.
Scientific Review Article: Sykes, BW and Jokisalo, JM. “Rethinking equine gastric ulcer syndrome: Part 3 – Equine glandular gastric ulcer syndrome (EGGUS) ”, Eq Vet Ed, July 2015, pp. 372-375.