What If the Missing Piece in Ulcer Recovery Isn't a Drug at All?
- 2 days ago
- 6 min read
For many horses, the pattern with squamous ulcers (which means the top part of the stomach - glandular ulcers is the bottom part) looks deceptively simple: the horse scopes with ulcers, the vet prescribes omeprazole, the ulcers heal, the horse looks better… and then, a few weeks after stopping the drug, the symptoms creep back. Owners often feel like they’re doing something wrong that is preventing ulcer recovery, but the truth is that this cycle is built into the biology of how omeprazole works.
Omeprazole is excellent at healing squamous ulcers because it suppresses acid production so effectively. While the horse is on it, the stomach becomes a much less hostile place, and the damaged tissue finally gets a chance to repair. The problem is what happens next. When the drug is stopped, acid production rebounds quickly. The stomach goes from a protected, low‑acid environment straight back to its normal, highly acidic state, often within days. If the underlying management factors haven’t changed, the newly healed squamous lining is suddenly exposed again.
This is why relapse is so common. The problems that follow are the ones owners recognise all too well. The horse becomes girthy again, or reluctant to go forward, or fussy with feed. Some get that dull, flat expression; others become sharper or more reactive. Work becomes inconsistent. Saddle fit gets blamed. Teeth get checked again. People start swapping feeds or supplements without a clear plan. The horse may lose topline or appetite. And because the symptoms are subtle at first, the relapse often goes on for weeks before anyone scopes again and realises the ulcers are back.
The cycle is emotionally draining for owners and painful for horses. It creates the impression that ulcers are a permanent condition or that the horse “just gets ulcers”, when in reality the issue is that omeprazole heals but does not protect, and the stomach needs support during the transition off the drug.
So the cycle isn’t a mystery. It’s a mismatch between a powerful pharmaceutical that suppresses acid and a management environment that still produces the same acid‑exposure risks once the drug is gone. Unless something changes - avoiding grains and starch, adding fibre and forage access, managing workload, reducing stress, altering feeding frequency - the horse ends up right back where it started.
Study on Feeding and Ulcer Recurrence / Recovery
Here’s an interesting study from 2024 about managing ulcers after treatment with omeprazole.
The study looked at ten adult horses with naturally occurring equine squamous gastric disease and followed them through a two‑month treatment and management period. Every horse was treated with omeprazole for the first month, exactly as normally happens in clinical practice. Half of the horses were also fed 1kg broken into 2 feeds of Fibre Beet - a commercial fibre mix made from beet pulp, alfalfa and oat fibre during that month, while the other half received no additional feed beyond their usual diet. At the end of the first month all ten horses had healed completely, which confirmed that omeprazole was effective regardless of whether the fibre mix was present.
The second month was where the differences emerged. Omeprazole was stopped for all horses, and Fibre Beet was then fed to every horse, including those that had not received it during the healing phase. When they were scoped again at the end of this second month, three of the five horses that had only started the fibre mix after omeprazole was withdrawn had redeveloped ulcers. In contrast, none of the horses that had been on the fibre mix from the beginning showed any recurrence. The authors noted that this difference was statistically significant, even though the study was small.
The researchers suggested several reasons why Fibre Beet may have helped prevent recurrence. Beet pulp provides pectin, which can form a protective gel‑like layer in an acidic environment. Alfalfa contributes calcium and protein, which buffer stomach acid while the feed is present. Oat fibre adds bulk and slows gastric emptying. Together (they say - see below on oaten fibre), these ingredients appear to create a more stable gastric environment at the exact time when the stomach is most vulnerable - the period immediately after omeprazole is stopped.
The study does not claim that Fibre Beet speeds healing or replaces omeprazole. Instead, it shows that feeding this type of fibre blend during the healing phase and continuing it afterwards may reduce the likelihood of ulcers returning. The authors are careful to point out that the sample size was small and that management factors were not standardised, but the signal is still meaningful: pharmaceuticals heal, and the right fibre support seems to help keep horses healed once the drug is withdrawn.
Before you run out and buy a pallet of Fibre Beet
Bear in mind that British Horse Feeds - the manufacturer of Fibre Beet paid for the study. And Tom Shurlock, one of the two authors, is an equine nutrition consultant for British Horse Feeds.
Also, ALL the horses in the study that were fed Fibre Beet alongside omeprazole didn’t relapse? Happy days. But if there were only 10 horses in the entire study, and half of them were in the control group - we’re only talking about 5 horses. The results may not be as glowing in a larger study.
That being said, many, many horse owners really struggle with the omeprazole cycle, and it’s horrible for horses. So if this is you, and you're facing another round of omeprazole, maybe give Fibre Beet a try and see how you go beyond the treatment period.
Price Comparison - Gut Support for Ulcers
Fibre Beet on an ongoing basis is definitely cheaper than round-after-round of GastroGard. You're looking at somewhere between $1200 and $1800 for a 28 day treatment program.
On average, 1kg of Fibre Beet works out at about $2.75 per day, which is a similar price per dose to a very popular and aggressively marketed gut health product. If you're on Instagram, you will know which brand I am talking about. Allegedly. (Although, that cost is on top of whatever you're paying for the feed that carries the supplement.)
We can break down the individual ingredients on that particular supplement and compare the price individually. At soundadvice.shop you will find Mycosorb A+, Yea Sacc, Calcium Carbonate and Calm Mix (magnesium and a prebiotic). If you were to combine a 10g dose per day of each of those products, that would be about $1.20 per day. Less than half the price.
We don't sell carbohydrase digestive enzymes - but a horse really only needs those if you are feeding large amounts of grain, sweet feeds and starch. We don't recommend that for any horse, but particularly not for a horse that is recovering from ulceration.
We also don't sell lithothamnion (red marine algae) currently, but we can source it if you're interested. It's not expensive. At a 10g dose we could probably offer it for less than 50c per day.
Would the Individual Ingredients Produce the Same Results?
Fibre Beet takes a very long time to soak (a recommended 45 minutes??). It would be interesting to know if the same results apply to horses have had ulcers in the past and are fed straight lucerne (either as chaff of hay) and beet pulp in whatever brand, which soaks quicker much.
It would also be very illuminating to see how much oaten ‘fibre’ contributes to the outcome, since their reason for including it in the study was merely to “add bulk”. Since oaten chaff/hay is typically high in sugar (frequently over 20%), it’s not one we normally recommend - especially for horses who have any sort of foot soreness, whether that be fat founder ponies or OTTBs, who are generally disposed to ulceration.
Please note - we're not being paid by British Horse Feeds to tell you about this study. We’re not paid by any feed companies to recommend specific products. We’re only paid by our beautiful Sound Advice customers. So if you find these articles entertaining and useful, you can support us by buying our products.
Here are some products our regular customers routinely buy who's horses have gut issues, including recovering from ulcers. They may be worth trialing, either individually or stacked, to see if they are a good match for your horse.
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