Yes, you can ride a horse with gastric ulcers, but how much and how hard depends on the severity of the ulcers and whether treatment is underway. Most horses with ulcers continue working at some level. In fact, gastric ulcers are so common in performance horses that many are ridden regularly without anyone realizing they have them. Studies show ulcer prevalence of 80 to 90% in racehorses in active training, around 60% in show horses, and 67% in endurance horses.
That said, exercise itself makes ulcers worse. The goal is to manage the condition while your horse works, not to ignore it.
Why Exercise Makes Ulcers Worse
A horse’s stomach is divided into two regions. The lower portion is lined with glandular tissue that can handle acid exposure. The upper portion is lined with squamous tissue, similar to the lining of the esophagus, and it has almost no natural defense against stomach acid.
When a horse exercises, two things happen. First, acid production increases while blood flow to the digestive tract drops. Second, and more importantly, the movement compresses the stomach and causes acidic fluid to splash upward onto that vulnerable upper lining. Walking produces less splash than trotting, and trotting less than cantering or galloping. The faster and more intensely your horse works, the more acid exposure the squamous tissue receives. This is the core reason exercise and ulcers don’t mix well, and it’s also why longer, harder sessions carry more risk than a light hack.
Signs Your Horse Is Uncomfortable Under Saddle
Some horses with ulcers show no obvious signs of pain while being ridden. Others make their discomfort very clear. The tricky part is that ulcer symptoms under saddle tend to be nonspecific, meaning they look like behavior problems or training issues rather than a medical condition.
Common signs during tacking up and riding include:
- Girthiness: pinning ears, nipping, swinging the head around, or flinching when the girth is tightened. Pressure from the girth sits right over the stomach area and can aggravate discomfort.
- Reluctance to move forward or a generally sour attitude about work.
- Tail swishing or slapping that isn’t related to flies.
- Hyperreactivity: spookiness or tension that seems out of character.
- Weight shifting and hind limb kicking toward the belly.
Away from riding, you might also notice your horse gazing at or nipping at the area just behind the elbow, doing deep downward-dog-like stretches, eating hesitantly, or sipping water tentatively rather than drinking normally. These behaviors often appear in clusters. If your horse is showing several of them alongside poor performance, ulcers deserve serious consideration.
How to Ride Safely During Treatment
The standard medical treatment for squamous ulcers (the most common type) runs about 28 days, though healing often occurs within 21 days. For glandular ulcers, which respond more slowly, a minimum of 8 weeks of treatment is typical. During this window, most veterinarians allow continued riding with some modifications.
Reduce intensity first. If your horse is in heavy training, dial it back. Light to moderate work is generally better tolerated than repeated hard sessions. You don’t necessarily need to stop riding entirely, but asking a horse with active ulcers to gallop, jump at full height, or drill difficult exercises for extended periods means more acid splash and slower healing.
Pay attention to what your horse is telling you. If the behavioral signs listed above get worse during or after a ride, that’s useful information. As treatment progresses, many owners notice a marked improvement in attitude and willingness, sometimes within the first week or two. That improvement is a good sign, but it doesn’t mean the ulcers are fully healed. Finishing the full course of treatment matters.
Feed Before You Ride
One of the simplest things you can do is feed your horse forage before tacking up. A stomach full of hay acts as a physical mat that absorbs acid and reduces how much splashes onto the upper stomach lining. Long-stem hay provides especially good coverage.
Alfalfa hay has been shown to decrease gastric ulcer formation specifically. Its natural calcium content helps buffer stomach acid. If you can arrive early enough to let your horse eat hay before you ride, that alone offers meaningful protection. Even a small amount is better than riding on an empty stomach. A horse that hasn’t eaten in several hours has a stomach full of acid with nothing to absorb it, which is the worst-case scenario for acid splash during exercise.
Tack Adjustments That Help
Because girth pressure sits directly over the stomach area, it can amplify discomfort in a horse with ulcers. This doesn’t mean you can’t use a girth, but it’s worth evaluating your setup. A girth that’s too tight, too narrow, or poorly shaped for your horse’s body can make things worse. Anatomically shaped girths that distribute pressure more evenly and sit slightly further back from the elbow area may reduce irritation. Make sure your girth is clean and the skin underneath is healthy, since girth galls or skin infections on top of ulcer sensitivity will compound the problem.
Tighten the girth gradually rather than cinching it in one pull. Some riders find that walking their horse for a few minutes before making the final adjustment helps the horse settle.
When to Scale Back or Stop
Mild ulcers in a horse that’s already on treatment and showing no behavioral signs under saddle generally don’t require time off. But if your horse is visibly painful, refusing to work, losing weight, or showing worsening behavior despite treatment, it’s reasonable to reduce work significantly or give them a break until a follow-up gastroscopy confirms healing.
A repeat scope before stopping medication is recommended to make sure the ulcers have actually resolved. Ulcers can look better on the outside (improved behavior, better appetite) before the stomach lining has fully healed. Stopping treatment early or returning to high-intensity work too soon is one of the most common reasons ulcers recur. For squamous ulcers, expect about three to four weeks before returning to full work. For glandular ulcers, plan on at least eight weeks of treatment before ramping back up.