Changes

====Intrinsic ulcerogenic factors<ref name="Nadeau">Nadeau, J.A, Andrews, F.M (2009) ''Science: Overviews'' Equine gastric ulcer syndrome: The continuing conundrum.  ''Equine Vet J'', 41(7):611-615.</ref>====

====Intrinsic ulcerogenic factors<ref name="Nadeau">Nadeau, J.A, Andrews, F.M (2009) ''Science: Overviews'' Equine gastric ulcer syndrome: The continuing conundrum.  ''Equine Vet J'', 41(7):611-615.</ref>====

HCl and a gastric pH persistently below 4.0 are the most significant factors in gastric ulceration.  Volatile fatty acids (VFAs), lactic acid and bile acids act synergistically with HCl to cause changes in squamous mucosal bioelectric properties (the first sign of acidic damage).  VFAs and lactic acid are by-products of bacterial fermentation of sugars in concentrate diets.

The most significant factors promoting gastric ulceration are HCl and a gastric pH persistently less than 4.0.  Volatile fatty acids (VFAs), lactic acid and bile acids augment the changes in squamous mucosal bioelectrical properties induced by HCl (the first sign of acidic damage).  VFAs and lactic acid are by-products of the bacterial fermentation of sugars found in concentrate diets.

*'''Hydrochloric acid''' damages the squamous mucosa by compromising the outer cell barrier.  It then diffuses into the squamous cells of the ''stratum spinosum'', inhibiting cellular sodium transport and causing cell swelling, necrosis and eventual ulceration.<ref>Nadeau, J.A, Andrews, F.M, Patton, C.S, Argenzio, R.A, Mathew, A.G, Saxton, A.M (2003) Effects of hydrochloric, acetic, butyric, and proprionic acids on pathogenesis of ulcers in the nonglandular portion of the stomach of horses.  ''Am J Vet Res'',64:404-412.</ref><ref>Nadeau, J.A, Andrews, F.M, Patton, C.S, Argenzio, R.A, Mathew, A.G, Saxton, A.M (2003) Effects of hydrochloric, valeric, and other volatile fatty acids on pathogenesis of ulcers in the nonglandular portion of the stomach of horses.  ''Am J Vet Res'', 64:413-417.</ref>

*'''Hydrochloric acid''' compromises the outer cell barrier of the squamous epithelium.  It then diffuses into the cells of the ''stratum spinosum'', inhibiting cellular sodium transport and causing cell swelling, necrosis and eventual ulceration.<ref>Nadeau, J.A, Andrews, F.M, Patton, C.S, Argenzio, R.A, Mathew, A.G, Saxton, A.M (2003) Effects of hydrochloric, acetic, butyric, and proprionic acids on pathogenesis of ulcers in the nonglandular portion of the stomach of horses.  ''Am J Vet Res'',64:404-412.</ref><ref>Nadeau, J.A, Andrews, F.M, Patton, C.S, Argenzio, R.A, Mathew, A.G, Saxton, A.M (2003) Effects of hydrochloric, valeric, and other volatile fatty acids on pathogenesis of ulcers in the nonglandular portion of the stomach of horses.  ''Am J Vet Res'', 64:413-417.</ref>

====Extrinsic ulcerogenic factors====

====Extrinsic ulcerogenic factors====