When Colic Won’t Quit: Managing Recurrent Digestive Issues in Horses

Colic remains one of the most concerning conditions horse owners face. While many horses may experience a single episode in their lifetime, some develop recurrent colic — repeated episodes of abdominal pain that can range from mild discomfort to life-threatening emergencies. Understanding why some horses are predisposed to recurrent colic and learning how to manage those risks can help safeguard equine health and performance.

What is Recurrent Colic?

Recurrent colic is defined as multiple episodes of abdominal pain over a period of time. Episodes can vary in severity and may stem from different causes, but repeated colic signals an underlying predisposition or management issue. Unlike a one-off incident, recurrent colic often indicates that risk factors — such as diet, anatomy, or management — are consistently at play.

Major Risk Factors for Recurrent Colic

Several factors increase the likelihood of repeated colic episodes. These can be grouped into dietary, management, environmental, and anatomical/medical categories.

1. Dietary Risk Factors

• High concentrate or grain diets: Horses evolved to graze for long hours on fibrous forage. High-starch feeds can disrupt hindgut fermentation, leading to gas, acidosis, or impactions.

• Sudden feed changes: Rapidly changing hay or concentrates alters the gut microbiome, increasing risk.

• Low forage intake: Horses fed insufficient hay are more likely to experience reduced gut motility and gas buildup.

• Poor-quality or mouldy feed: Dusty, mouldy hay or grain can directly irritate the digestive tract.

2. Management Risk Factors

• Limited turnout: Horses confined for long periods have reduced gut motility compared to those grazing at pasture.

• Irregular feeding schedules: Horses are designed to trickle feed; inconsistent meal timing can increase colic susceptibility.

• Dehydration: Lack of water intake, especially in cold weather or during transport, can predispose to impaction colic.

• Stress: Frequent transport, competition, or changes in routine elevate stress hormones, which negatively impact digestion.

3. Environmental Risk Factors

• Sand ingestion: Horses grazing sandy pastures or fed on sandy ground can accumulate sand in the colon, causing recurrent discomfort.

• Seasonal changes: Colic risk increases with abrupt weather shifts that affect pasture quality, water consumption, and activity levels.

4. Anatomical and Medical Risk Factors

• Previous abdominal surgery: Horses that have undergone colic surgery may be prone to adhesions or altered motility.

• Dental problems: Poorly chewed feed can increase the risk of impactions.

• Parasites: Heavy parasite burdens, especially small strongyles, can damage the gut lining and predispose to colic.

• Individual predisposition: Some horses may have anatomical quirks, such as a narrow colon or mobile intestines, making them naturally more prone.

Identifying Horses at Risk

Research suggests that horses with a history of colic are significantly more likely to experience future episodes. 

Other red flags include:

• A horse prone to stress or with a “nervous” temperament.

• Horses with irregular access to turnout.

• Animals dependent on high-starch performance diets.

For owners of at-risk horses, proactive management becomes important.

Mitigation Strategies: Reducing the Risk of Recurrent Colic

1. Optimise Diet

• Maximise forage: Provide at least 1.5–2% of body weight in good-quality forage daily. Continuous access to pasture or hay mimics natural grazing.

• Limit concentrates: Keep grain meals small (<2kg per feeding) and spread across multiple feedings if concentrates are necessary.

• Introduce changes gradually: Any feed, hay, or pasture change should be phased in over 7–10 days to allow the gut microbiota to adapt.

• Use feed additives: Probiotics, prebiotics, or hindgut buffers may help stabilise digestion in prone horses.

2. Encourage Hydration

• Ensure clean, fresh water is always available.

• Offer warm water in winter, as horses often drink less when it is very cold.

• Provide electrolyte supplements during hot weather, travel, or heavy work to stimulate thirst and replace losses.

3. Improve Management Practices

• Regular turnout: Daily grazing or exercise supports gut motility and mental health.

• Consistent routine: Horses thrive on predictability; sudden schedule shifts can increase stress.

• Avoid feeding on sandy ground: Use feeders or mats to reduce sand ingestion; consider psyllium husk supplements for sand clearance if needed.

4. Monitor Health Closely

• Routine dental checks: Annual or biannual floating ensures proper chewing and reduces impaction risk.

• Parasite control: Use evidence-based deworming strategies guided by fecal egg counts.

• Weight management: Overweight horses are more prone to certain types of colic, while underweight horses may lack the resilience to recover well.

5. Reduce Stress

• Provide companionship and minimise unnecessary isolation.

• Train horses gradually for travel and competition environments to reduce anxiety.

• Ensure adequate recovery time after stressful events.

Veterinary Role in Managing Recurrent Colic

When a horse experiences repeated colic episodes, veterinary investigation is required. Diagnostic tools such as gastroscopy, ultrasound, bloodwork, and rectal exams can help pinpoint causes such as ulcers, adhesions, or motility disorders.

In some cases, management changes may be sufficient, while others may require medical interventions such as ulcer treatment or drenching. Collaboration between veterinarian and owner is key in long-term management.

Practical Case Example

Consider a performance horse experiencing recurrent mild gas colic during competition season. Investigation reveals:

• High-grain diet to maintain energy.

• Limited turnout due to travel.

• Stress from frequent transportation.

By gradually replacing some grain with fat-based energy sources, increasing hay intake, and offering electrolytes during travel, the frequency of colic episodes decreases significantly. This case illustrates how management adjustments can make a tangible difference.

Key Takeaways

• Recurrent colic is a warning sign, not just bad luck.

• Risk factors are often management-related: diet, hydration, stress, and turnout play central roles.

• Horses with a history of colic are more likely to repeat episodes and need tailored care.

• Preventive strategies — optimising forage, gradual feed changes, routine dental care, parasite control, and stress reduction — are essential.

• Veterinary input is critical to investigate underlying causes and guide long-term management.

Conclusion

Colic will likely always remain a challenge in equine management, but recurrent episodes do not have to be accepted as inevitable. By understanding the risk factors and taking proactive steps to mitigate them, horse owners can significantly reduce the likelihood of recurrence. The combination of good nutrition, consistent management, regular veterinary care, and attention to the horse’s individual needs provides the best defense against this troubling condition.

Ultimately, preventing recurrent colic is about creating an environment where the horse’s digestive system can function as naturally as possible — with steady access to forage, regular movement, and minimal stress. For owners, this means not only fewer emergency calls but also healthier, happier horses that thrive in their work and daily lives.