Equine glandular gastric disease in adult horses

Equine glandular gastric disease is a separate entity from equine squamous gastric disease and is, until proven otherwise, a syndrome with different underlying causes. Gastroscopy is the mainstay of diagnosis, with an understanding that what is seen at the pylorus may not reflect the whole picture of squamous or glandular disease. The pathophysiology is still not understood, which limits understanding of how to effectively treat the condition. Clinical signs relate to changes in broad themes including changes in temperament (including cutaneous hypersensitivity), rideability and appetite, which may result in weight loss. Risk factors for glandular gastric disease are different to squamous gastric disease and include exercise for more than 4 days per week, multiple caretakers, being less experienced at the discipline that they compete in and less adaptable to stress. Limitations in progress of understanding of this condition include a better understanding of the pathophysiology and what findings mean regarding clinical signs and response to therapy, consistent definitions of healing and improvement, evaluating adjunctive products as adjunctives and not as medicines and large multi-centre studies using appropriate statistics.