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Foregut or Hindgut? That’s The Question – Part 1


Knowing what sort of support your horse needs can be tough, but it can also make a big difference.

We know there’s a lot of confusion between your horse’s foregut health and hindgut health. After all, the process of breaking down food and absorbing nutrients is all technically “digestion,” so isn’t it all the same? Not quite. The organs in the foregut and hindgut have very different functions, and each area has unique health concerns. An unhealthy stomach is at risk for gastric ulcers, while an unhealthy hindgut is at risk for colic and other digestive upset. As if all that’s not complicated enough, colic is not only the primary problem in the hindgut, it’s also a general term for abdominal pain, which means mild, recurrent colic can also be a sign of gastric ulcers. However, for the purposes of this article, when we say colic*, we’re referring to problems (gas, impaction, twists, etc.) in the organs that make up the hindgut. Confused? Have no fear—SmartPak’s here to help! In Part 1 & Part 2 of this blog, we’ll look at each condition in greater detail, and identify ways you can help support your horse.


Can one small organ really make such a big difference in your horse’s health? Turns out, it can! Luckily, we’re here to help with a proven three-step plan to provide your horse with the ultimate gastric health support.

The word “gastric” means “of or pertaining to the stomach,” so gastric health focuses entirely on one organ—the stomach. While your horse’s stomach is relatively small, accounting for less than 10% of his total digestive capacity, it can cause some pretty big problems, including gastric ulcers.

Over 60% of performance horses suffer from gastric ulcers, a painful condition that can cause decreased performance, weight loss, and more. Luckily, there are clinically tested and proven ways you can treat and prevent ulcers and maintain overall gastric health.

Your horse’s body was designed for constant grazing (up to  hours per day!), which means the stomach is almost never empty. However, modern horsekeeping makes that tough to achieve. Often, a horse’s diet is composed of infrequent meals of hay and grain, with most of the day spent with an empty stomach. This leaves your horse’s sensitive stomach lining exposed to harsh gastric acids, which can cause gastric ulcers. Add to the mix that stress from training, travel, competition, and more can also contribute to ulcers, and you’ve got a recipe for an unhappy stomach.

The only way to accurately diagnose an ulcer is with an endoscopic exam performed by your veterinarian. However, there are some warning signs that you can watch out for, including:

  • Reluctance to eat or drink
  • Worsening attitude
  • Less-than-optimal performance
  • Dull hair coat
  • Weight loss
  • Agitation at feeding time
  • Mild, recurrent abdominal pain

If your horse has been diagnosed with gastric ulcers, you should work with your vet to develop a treatment plan that’s best for your horse. You can also learn about some proven ways to treat and prevent ulcers, and maintain overall gastric health, just keep reading!



If your horse has been diagnosed with a gastric ulcer, you should provide prescription therapy to allow the stomach to heal. Talk to your veterinarian about where you can get GastroGard® (omeprazole), the only product approved by the FDA to treat and heal equine gastric ulcers. No sign of ulcers? Skip to daily maintenance.

GastroGard is a unique flavored paste that contains omeprazole, a compound that helps heal stomach ulcers.

The specially formulated omeprazole in GastroGard suppresses acid by inhibiting the acid pumps in the mucosal lining of the stomach wall. This is important because the presence of gastric acid will continue to aggravate an existing ulcer, preventing healing. By shutting down the production of gastric acid, GastroGard provides an acid-free environment, which allows cellular regeneration in the stomach lining, essentially enabling the stomach to heal itself. The recommended treatment regimen includes a once-daily dose of GastroGard for  days, allowing the stomach plenty of time to heal. This treatment was proven to heal or significantly improve gastric ulcers by up to 99% in treated horses.


If your horse doesn’t have an ulcer, or his ulcer has recently healed, your main goal should be maintaining stomach health. A good gastric health maintenance plan includes a combination of diet and management changes, along with support from an appropriate supplement.

Focus on hay and other forage, ideally allowing your horse pasture grazing or free choice access all day. Large grain meals have been identified as a proven risk factor for gastric ulcers, so you should only add the minimum amount of grain (if any) your horse needs to maintain weight and performance, and aim to feed multiple small meals throughout the day.

There are other management changes you can make to help reduce your horse’s risk, including:

  • Increasing turnout time
  • Limiting the use of NSAIDs (such as bute)
  • Making any changes to workload or routine as gradually as possible

Adding a gastric health supplement to your horse’s program is a smart way to ensure he has the consistent, daily support he needs for a healthy stomach. In a recent university-led research study, SmartGut Ultra helped maintain stomach health in horses under stress, as well as horses who had been treated for gastric lesions. At the conclusion of the study, lead researcher Dr. Frank Andrews, Director of Equine Health at Louisiana State University, said, “If your horse is under stress, I recommend feeding SmartGut Ultra to help reduce your horse’s risk of developing ulcers.”

SmartGut® Ultra Pellets

As Low As: $68.95
(179 reviews)


Even the most well-managed horse will undergo the occasional bout of stress, which can increase the risk of gastric ulcers. Luckily, you can provide your horse with added support when he needs it most with UlcerGard® (omeprazole).


 $34.95 - $197.95
(141 reviews)

UlcerGard is the first and only nonprescription medication approved by the FDA for the prevention of equine gastric ulcers.

Like GastroGard®, UlcerGard’s active ingredient is specially formulated omeprazole, which suppresses acid secretion, preventing the formation of gastric ulcers. In fact, one study showed that using UlcerGard prevented gastric ulcers in 82% of horses when given once daily, while 86% of untreated horses developed gastric ulcers. Giving UlcerGard once daily during times of additional stress, like the few days leading up to and including travel and competition, can help reduce your horse’s risk even further.


Read Part 2 of this blog series, in which we talk all about colic & digestive health.

Posted in Health & Nutrition

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7 comments on “Foregut or Hindgut? That’s The Question – Part 1
  1. Jodi R says:

    Although I already know most of this and have battled both ulcers and colic in one of my show horses, this is wonderful information that can’t be passed around enough! Thank you for making this easily accessible to all of us! Great info to keep handy!

    • SmartPak SmartPak says:

      Jodi, you ROCK! Thanks for reading our blog and for sharing your awesome feedback. Helping riders like you take great care of your horses is the #1 mission of every SmartPaker, so I shared your kudos with the whole company :-)
      I hope your horses remain happy and healthy (sounds like they’re lucky to have such a great mom!). If there’s ever anything we can do to help you take great care of them, please don’t hesitate to let us know.
      Thanks again, and have a great ride! – SmartPaker Sarah

  2. Melanie O'Shea-Chaparro says:

    This info came at a great time! One of my horses just finished a 30 day course of Gastrogard last week. Today I noticed him exhibiting some of the same behaviors that led us to get him scoped in the first place. I was looking for a good maintenance plan and it sounds like you have just the thing. Thank you!

  3. Eve R Mead says:

    “Stormy” has been with Us since 8mo.@is now 6..she is an Arab/BlueRoanTobiano Paint. She has been on SPk maintaince since Her Purchase. She is in great shape@for last month.has live in a Herd of 36 @ Pasture contained@lives naturally. She is on EZmag,SmartCombo,BuggOff…She is Beautiful….Thank U SmPak.!

    • SmartPak SmartPak says:

      Hi Eve, it’s great to hear that Stormy is doing so well! Thanks for letting us help you keep her happy, healthy, and beautiful! – SmartPaker Sarah

  4. Carissa Nickols says:

    I can attest that this plan does work! I have a mare that started to colic for no apparent reason. The episodes became more and more frequent and sometimes would occur more than once in a weeks time. I had never treated a horse for ulcers as I’ve never had to deal with this issue. As the colics became increasingly more frequent, I noticed that she started dropping weight and had a very dull, dry coat. The colics were strange in that she would still drink and poop as normal but her poop would be very loose and she would lay down a lot, stretch as if trying to urinate, very lethargic and would actually burp. I took her to the vet and had blood work done which all came back normal. I then made sure that my worming program was up to par. Lastly, I treated her with a daily dose of Ulcergaard for 2 months. I then read an article that SmartPak put out based on the fact that after you quit dosing with Ulcergaard the stomach can have a rebound effect with a higher production of gastric acid and the article recommended the Smart Gut pellets. I can say that she has been on the Smart Gut pellets for 10 months now. We have not had any episodes of colic and her coat looks AMAZING!! She has gained all her weight back and has a great body score. I keep a few tubes of Ulcergaard on hand and if I know I’m going to be traveling I will give the maintenance dose the day before, the day of, and the day after. Although the initial treatment of Ulcergaard is expensive- it is WELL worth it!!! I also have her on a regular worming program and have her teeth done on a regular basis. Although these might seem like mute points to some, I can attest that they all go hand in hand and are VERY important to the horses overall health!

  5. Julia says:

    I thought my horse had mild colic but now am wondering if he has ulcers. He won’t let anyone touch his rear underbelly without squealing. He keeps turning around to nibble on his rear toes. He looks a little tucked up. I didn’t think it was a bad case of colic as he was still eating pooing and walking around (although was swishing his tail a lot). I gave him a mild salt flush (ie syringes two cupfuls of salty water into him with some Bute) and he came better. The next day I noticed bumps and thought… Oh, so he was bitten (aesthetes been lots of wild wasps around) so I gave him antihistamines, but he’s still quite tender around his rear lower belly cage. Most gets are pretty ordinary around mild colic and will recommend buscapan or will give an injection. Prior to getting to that point, I’m interested in your thoughts?

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