No peptide has been shown to help gastric ulcers in horses. BPC-157 is sold with gut claims, but it returns no PubMed results at all in horses. A gastroscopy confirms ulcers. Omeprazole is the only FDA-approved ulcer medicine for horses, and it works alongside more forage, less starch and a steadier routine.
What is EGUS?
Equine gastric ulcer syndrome (EGUS) is the umbrella name for two different diseases in two parts of the stomach. They have different causes and respond differently to treatment, and one does not predict the other. That is why a vet needs to see which one your horse has. The gastric ulcers page has a short overview.
| Compare | Squamous disease (ESGD) | Glandular disease (EGGD) |
|---|---|---|
| Where | Upper stomach, near the margin with the lower part | Lower, acid-making part |
| How common | About 80% of lesions | About 20% of lesions |
| Causes | Acid splashing up. Linked to grain, gaps in feeding and hard work | Less well understood |
| Response to omeprazole | Usually good | Slower. May need other medicines too |
Why does my vet want a gastroscopy?
Because it is the only way to know. Signs are vague: poor performance, poor appetite, weight loss, mild colic or a change in attitude. A European specialist consensus says signs are poorly linked to ulcers, and that gastroscopy is the only reliable way to identify them in a living horse. Blood and fecal tests do not replace it.
Your horse goes without food beforehand so the stomach is empty, then a long camera is passed through the nose. The same consensus does not recommend treating without a scope. Signs alone can mislead, and the two diseases need different plans. Merck reports ulcers in at least 90% of racehorses in training and about 40% to 60% of other performance horses, so finding some is not the end of the search for what else may be wrong.
What do vets usually prescribe?
Omeprazole is the main treatment. The Merck Veterinary Manual says it is the only medicine approved by the FDA to treat and prevent EGUS. In studies cited by the consensus, about 78% of squamous lesions healed on a standard course, against about 25% of glandular lesions, which is why rechecks matter. Merck says glandular disease may need a longer course.
Your vet may add other medicines. Sucralfate may help alongside omeprazole for glandular disease, and misoprostol is another option for that form. Antacids give short relief and the consensus does not support them as the only treatment. Your vet sets the plan and the amounts.
Which feeding and management changes matter?
These changes are part of treatment, and they apply whether or not your horse takes a medicine. Merck warns that if the risk factors continue, ulcers are unlikely to resolve without medical treatment. The consensus and Merck point to these steps:
- Constant access to good pasture if you can, otherwise free-choice hay or frequent forage meals
- Straw as part of the forage, never all of it
- As little starch and grain as your horse's work allows, and no sweet feed
- Water available at all times
- No long gaps without feed
- Care with electrolyte pastes, which have been linked to squamous disease
- A calm routine: stabling, travel and social changes all count as stress
The BPC-157 claim: what is known?
Lab interest is the only basis for it. BPC-157 has been studied in the lab, mostly for gut and tissue healing, and sellers carry that over to horses. It is not officially tested in horses and not FDA-approved for animals. PubMed returns no BPC-157 results at all for horses, so there is no horse data on ulcers, on safety or on a safe amount. KPV, studied in the lab for gut inflammation, is in the same position: not officially tested in horses, not FDA-approved for animals, and with no clinical trial in PubMed.
Capsules, oils and treats raise one more question. Nobody has published how much of any of these survives a horse's stomach, so a label tells you what went in, not what your horse gets.
A 2023 study shows why this matters. Fourteen mares with squamous disease moved to free-choice hay, a small low-starch feed and a set routine. Half also got a hydrolysed collagen supplement. Ulcer scores fell in both groups, with no added effect from the supplement, and 7 of 14 horses healed. It was a small study with no omeprazole group, but it shows how easily a product can get credit for what management did.
If your horse competes, no peptide belongs in the plan. BPC-157 is not cleared by FEI rules just because it is not named.
When to call the vet, and what to ask
Colic needs a vet now, even if you think ulcers are the reason. Poor appetite, weight loss or a horse that turns sour in work needs a booked visit, and a video call with a licensed vet can help you decide how soon. Tell your vet about every supplement and product your horse gets, then ask:
- Should we do a gastroscopy, and which part of the stomach will you check?
- Is this squamous, glandular or both?
- When should we recheck, and what happens if it hasn't resolved?
- What should change in the feed, the routine and the work?
- Could something else be behind these signs?
What vets usually do
Ulcer medicine (omeprazole), more forage and turnout; colic is an emergency.
BPC-157 for gastric ulcers: what is known
A video call with a licensed vet helps you decide how urgent it is and what to tell your own equine vet. Colic or a horse that won’t put weight on a leg needs a vet visit now. Start a vet call Paid link
Questions horse owners ask
Does BPC-157 help horse ulcers?
Nobody can say, and there is no evidence that it does. PubMed returns no BPC-157 results at all for horses. It is not FDA-approved for animals, and a seller's gut claims come from lab work, not horses. Ask your vet about gastroscopy and omeprazole.
Is omeprazole the only option?
It is the only medicine FDA has approved to treat and prevent EGUS, according to Merck. Vets may add sucralfate or misoprostol for glandular disease. Feeding and management changes go alongside any medicine, and your vet will set the plan.
Can I treat for ulcers without a gastroscopy?
A specialist consensus does not recommend it, because signs are poorly linked to ulcers and the two forms need different plans. Merck notes a vet can make a presumptive diagnosis if a scope is not available. Ask your vet which route suits your horse.
Can ulcers resolve with feeding changes alone?
Sometimes. In a 2023 study of 14 mares, squamous disease improved on free-choice hay and a steady routine without omeprazole. Merck warns that ulcers are unlikely to resolve without medicine if the risk factors continue, so ask your vet.
Are gut supplements worth it?
The evidence is limited. A European specialist consensus found mixed results across products. Some showed promise and others did not. Label accuracy is a separate question. Check any product with your vet, and with your competition rules if your horse competes.
Sources
- Merck Veterinary Manual, Gastric Ulcers in Horses. Last updated Jul 2026. Open
- Sykes BW et al. European College of Equine Internal Medicine Consensus Statement: Equine Gastric Ulcer Syndrome in Adult Horses. J Vet Intern Med, 2015. Open
- Kranenburg LC et al. Changes in Management Lead to Improvement and Healing of Equine Squamous Gastric Disease. Animals, 2023. Open
- PubMed, BPC-157 in horses, all study types: no results, checked 6 Nov 2026. Open
- PubMed, KPV in horses, clinical trials only: no results, checked 6 Nov 2026. Open
- FDA, Approved Animal Drug Products (Green Book): BPC-157 not listed. Open
- FEI, 2026 Equine Prohibited Substances List. Open