SummaryRecent studies report the use of a range of treatments for equine glandular gastric disease, but with all treatments, refractory disease is common. The evidence for some widely used treatments is very poor. Treatments may aim to suppress acid production (e.g. omeprazole), promote mucosal barrier function (e.g. misoprostol/sucralfate), or both. It is imperative that all treatments are combined with management to minimise known risk factors, primarily physiological and psychological stressors.