You have the diagnosis, now you need to know how to treat hindgut ulcers.  Treating hindgut ulcers is a relatively new endeavour, so there is not a wide range of treatment options.

Research has shown the best way for treating hindgut ulcers is a three-pronged approach- medication, diet, and probiotics.


Medication: Sucralfate

Using sucralfate to treat hindgut ulcers is still a bit of an unknown to many horse owners.  Fortunately, we are learning that sucralfate is a wonderful addition to treating hindgut ulcers.

Sucralfate works differently than omeprazole, which is used to treat gastric ulcers.  Rather than reducing acid production, like omeprazole, sucralfate is a coating agent.  Sucralfate forms a viscous substance when exposed to an acidic environment.  This substance coats the lining of the stomach and intestine, as well as filling in and protecting the lesions created by ulcers.

Once coated, hydrochloric acid produced in the stomach can no longer cause further damage.  Sucralfate lasts approximately 6 hours, so multiple doses are needed in order for your horse to be protected throughout the entire day.

Diet can keep your horse ulcer free

You have decided to treat your horse for hindgut ulcers, but what will keep them from coming back? 

Dietary changes are necessary in order to keep your horse ulcer free.  Horses are designed to eat small meals throughout the day.  Unfortunately, we have adjusted their routine to best suit us.

Creating a feeding regime similar to their natural environment by increasing the amount of forage offered, and reducing the amount of carbohydrate rich grains, will help to create a less acidic environment in your horse’s gut.


The theory behind adding probiotics to your horse’s diet is that they will provide needed beneficial bacteria in an environment that has been interrupted due to external factors.

Intestinal bacteria can be dramatically altered by many factors: deworming, vaccinations, antibiotics, parasitic infestations, starch/sugar overload, and stress.  Adding a probiotic of at least 20 billion CFU (colony forming units) helps restore beneficial bacteria,  allowing t food to be fully digested and fermented in the hind gut.

Treating hindgut ulcers requires a commitment.  Not only is medication needed, but dietary/lifestyle changes, as well as the addition of probiotics will help to ensure your horse stays happy and healthy.