RETHINKING EGUS: EQUINE SQUAMOUS GASTRIC ULCER SYNDROME

摘要

The term Equine Gastric Ulcer Syndrome (EGUS) has been in use for some time but it is commonly misrepresented which leads to significant confusion. By definition the term refers to a syndrome, within which numerous disease entities exist and distinguishing between the separate diseases and/or disease syndromes is important. The proposed pathophysiology of disease of the squamous and glandular mucosa are different, different risk factors have been described for squamous1"5 and glandular6 disease, thepresence of squamous and glandular ulceration within an individual are unrelated7-9 and the response of glandular ulceration to treatment with omeprazole is inferior to that of squamous ulceration10^12.As such, the direct extrapolation of findings from the squamous mucosa, which is by far the better studied of the two, to the glandular mucosa is inappropriate. Instead, disease of the squamous mucosa should be considered as a distinct entity to diseaseof the glandular mucosa. Further, it is likely that within both the squamous and glandular mucosa that there is more than one primary etiological process that causes disease and as such the use of the terminology 'syndrome' is appropriate. In line with this over the next two lectures diseases of the squamous and glandular mucosa will be discussed separately. The term Equine Squamous Gastric Ulcer Syndrome (ESGUS) will be used to discuss diseases of the squamous mucosa, while the term Equine Glandular Gastric Ulcer Syndrome (EGGUS) will be used to discuss diseases of the glandular mucosa.