Helping Your Horse Heal: Understanding Colic, Ulcers, and the Power of Nutrition
By Katey – KC Equine Wellness
Colic and gastric ulcers are two of the most common gastrointestinal issues in horses. They’re often viewed as unrelated, one an emergency, the other a chronic management concern, but they overlap far more often than most owners realize. Colic remains the leading cause of death in horses aged 1–20, and research consistently shows high ulcer rates in horses presenting with gastrointestinal signs. Large gastroscopy studies involving over 100 horses frequently report ulcer prevalence between 50–90%. Many veterinary hospitals also note that a significant number of horses scoped during colic episodes are found to have ulcers, reinforcing how often these conditions coexist. Interestingly, control groups of horses without colic also show notable ulcer rates, which tells us two things: ulcers are extremely common, and horses express them very differently.
Severity doesn’t reliably match symptoms. A horse with grade 4 ulcers may appear comfortable, while another with mild lesions may show significant discomfort or colic‑like behavior. This variability is one reason ulcers are so easily missed. The overlap between colic and ulcers doesn’t mean one always causes the other, but it highlights how interconnected the equine digestive system is—and how often these issues appear together in both research and real‑world practice.
Both conditions share many of the same triggers: high‑starch or high‑sugar diets, processed commercial feeds, mineral imbalances, inconsistent feeding schedules, limited forage, confinement, travel, competition stress, intense exercise, NSAID use, medications, fasting, and vaccination during periods of high inflammatory load. These pressures disrupt motility, alter the microbiome, increase acidity, and reduce digestive resilience. This is why many ulcer‑positive horses show vague, recurrent colic‑like signs such as stretching out, flank watching, lying down more often, picky eating, or belly discomfort.
While research hasn’t proven a single direct causal pathway, the relationship is clear: ulcers and colic frequently coexist and influence one another. Ulcer pain can mimic or contribute to low‑grade colic episodes, and ulcers may also develop secondary to intestinal disease, including colic itself. Reduced forage intake, pain, and stress further alter motility, increasing the risk of gas or spasmodic colic. These conditions rarely exist in isolation.
One of the most overlooked contributors in both colic and ulcer cases is nutrition. Stress, workload, environment, and medical history all matter, but nutrition is the foundation that influences every system in the body. Too often, a horse is treated with medication and immediately returned to its normal routine, diet, and workload. Many are even placed on “ulcer‑care” feeds that are still high in sugar, additives, and inflammatory ingredients. Medication may reduce symptoms, but it often does not correct the underlying dysfunction.
Highly processed feeds, high sugar content, and multi‑mineral mixes create a perfect storm: blood sugar spikes, microbiome disruption, altered hindgut pH, increased stomach acidity, fermentation gas, and mineral imbalances. By the time many horses reach me, multiple systems are dysregulated: stomach, hindgut, microbiome, nervous system, immune system, inflammatory pathways, and stress axis. Medication can stabilize a crisis, but it cannot rebuild a system that has been nutritionally unsupported for months or years.
Colic and ulcers are deeply interconnected, and while many factors contribute to their development, nutrition is one of the most influential, and most commonly overlooked. Medications have an important role, especially in acute situations, but they were never designed for long‑term use or full‑system repair. What I often see is this: a horse is diagnosed, treated, and assumed to be “fixed,” yet nothing in their daily life changes. No nutritional overhaul, no rest, no microbiome support, no correction of mineral imbalances, no reduction in stressors. They return to the same routine that contributed to the issue in the first place, and relapse becomes almost inevitable. Healing requires addressing the root contributors, not just suppressing symptoms.
A biologically appropriate, therapeutic diet supports the entire digestive ecosystem: forage‑first, low sugar and starch, whole foods, balanced minerals, targeted therapeutic nutrition, microbiome support, and reduced inflammatory load. When nutrition is prioritized, the stomach heals, the hindgut stabilizes, motility normalizes, inflammation decreases, and recurrence becomes far less common. Therapeutic nutrition isn’t optional,it’s foundational. This is where holistic care shines: supporting the horse as a whole being, not just treating symptoms. When we feed the body what it is designed to thrive on, every system becomes more resilient, and the cycle of recurring colic and ulcers finally begins to break.
When I work with a horse, my focus is on identifying that horse’s unique contributing factors and root causes. From there, I build an individualized program that evolves throughout the healing process. I provide consistent support, communication, and follow‑up for both the horse and the human, adapting as the horse changes. The process continues until the horse is regulated, stable, and the human feels confident with the tools they need to support long‑term wellness.
If this information resonates and you want to explore what therapeutic nutrition could look like for your horse, you can book a consultation. I’ll help you identify the underlying patterns and create a plan that supports whole‑body healing.