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==Treatment==
==Treatment==
===Treatment problems===
The prevalence of gastric ulcers in horses remains high regardless of the common use of antiulcer treatments. This has been attributed to the expense of recommended products encouraging subtherapeutic and curtailed dosing schedules(Orsini et al 2003 in Nadeau 2009). Omeprazole and ranitidine must be administered for at least 28 days for adequate ulcer healing.(Nadeau 2009)
The prevalence of gastric ulcers in horses remains high regardless of the common use of antiulcer treatments. This has been attributed to the expense of recommended products encouraging subtherapeutic and curtailed dosing schedules(Orsini et al 2003 in Nadeau 2009). Omeprazole and ranitidine must be administered for at least 28 days for adequate ulcer healing.(Nadeau 2009) In the USA, compounded omeprazole from bulk powders are used as a cheaper substitute for the FDA approved products. However, these formulations lack efficacy and are not regulated (Nieto et al. 2002; Merritt et al. 2003; Orsini et al. 2003).(Nadeau 2009)
A considerable challenge lies in the management of abdominal pain associated with EGUS, since the commonly used NSAIDs for pain control may worsen and even induce further ulcerative lesions.<ref>Videla, R, Andrews, F.M (2009) New perspectives in equine gastric ulcer syndrome.''Vet Clin North Am Equine Pract'', 25(2):283-301.</ref> Another challenge is the horse that cannot take oral medication. However, Andrews and colleagues (2006) have demonstrated the efficacy of an omeprazole powder, adminstered IV in sterile water, which signifcantly increased the pH of equine gastric contents and may be useful in problem horses.
Acid suppression
Acid suppression