Chances are, if your horse does any type of showing, he/she is likely to have ulcers if you are not actively taking steps to prevent them. Scientific research has shown that 2/3 of performance horses of all equine disciplines have gastric ulcers. How would you know?
The best thing to do is have your veterinarian perform a gastroscopy. This is done by sedating the horse and looking directly at the different portions of the stomach through a camera at the end of a long tube that is passed through the horse's nose. Depending on the location and severity of the horse's ulcers, treatment varies from reducing the acidity of the stomach contents to allow existing ulcers to heal, coating the stomach lining with a medication that protects ulcerated areas, and increasing mucus production by stomach cells to protect them from acid. If ulcers become infected, antibiotics may also be necessary.
For some horses, a few small ulcers cause a lot of pain and greatly diminish performance, and may even lead to behavior such as biting (especially when tightening the girth/cinch), bucking, cribbing, and refusing to jump. Ulcers can also affect a horse's appetite, weight, and coat quality. Other (very stoic) horses may have many large, deep ulcers and not show any outward signs, but their performance is often noted to improve following treatment. After treatment the gastroscopy should be re-checked to determine if the treatment course was long enough to resolve all ulcers, or if additional treatment is needed.
Some owners may elect to try standard treatment and see if the clinical signs resolve, but if they don't and gastroscopy is performed after treatment it makes the findings and correlation with clinical signs more difficult to interpret. Also, most insurance companies will not cover the cost of ulcer medications without definitive diagnosis by gastroscopy.
The images below show an example of severe stomach ulcers as seen through the gastroscope.
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