Principal Body System: Digestive
Definition: A long tube called the gastrointestinal (GI) tract and associated organs, i.e. salivary glands, liver and pancreas.
Function: Performs the physical and chemical breakdown and absorption of food for use by cells, and eliminates solid and other waste.
All dis-ease begins with the gut. So said Hippocrates, who was way ahead of his time, because all these centuries later, there's no doubt about it. The digestive system is the Mother of all the Systems, with the large intestine, aka the 'hindgut', the Mother of all the Organs - everything starts with the gut.
A healthy gut is the ultimate gatekeeper of good health, and a healthy microbiome the game-changer - this may be the decade, or even the century, of the microbiome. The gut microbiome is probably the most important regulator of health; there are 100-trillion gut microbes sending messages throughout the body, interacting with the hormones, the immune system, brain chemistry, and every other system in the body. When the microbiome's microbes are are out of balance, a seriously malfunctioning body is the result. It really is as simple as that.
How a horse eats
(and we need to know this, because if we mess with this, which we do - often, it all goes horribly wrong)
The gut system isn't just a tube where food gets shovelled in one end and eventually comes out the other end - well, it kind of is, but the whole gut system, from one end to the other, has a massive job to do in between. The good news is that a horse knows exactly how to do it - it's us that messes with it 😉
First up, it's all about the forage, and trust me - size matters
It all starts with the initial chewing process which mechanically breaks down the forage into tiny pieces of between 2-5mm - this length is vitally important as the whole digestive process, including peristalsis motility, takes place through a very long - and thin - tube, from start to finish, so a successful digestive process is entirely governed by the chewed length of the fibre.
*Choke Alert - if the food isn't chewed small enough, this can make horses prone to choking. We know that horses don't generally chew the contents of their feed bucket slowly - it's more of an inhale 😉 - so we need to take care of the particle sizes, especially with chopped pieces of carrot or apple. Make sure they're chopped into tiny pieces because if they're not chewed properly they can get stuck at the bottom of the oesophagus, too large to pass through the sphincter entrance to the stomach/foregut.
The horse will naturally bite the appropriate length of forage for his mouth, just like we put an appropriately-sized mouthful of food onto our fork – too small and we’ll swallow it straight down; too big and we’re chewing for ages followed by an uncomfortable swallow and most likely a bit of indigestion! The horse does the same – from free-growing long grasses (not what we have here in the UK), the horse will bite the right size mouthful size with their front teeth, then ‘roll’ it into the toothless gap where we put the bit. This is a tasting area - horses are very particular about what they eat as once they've committed to chew and then swallow means the job's done, ready for the huge process of digestion. Unlike us humans or dogs, they can't vomit anything nasty back up. Horses don't have this luxury as they can't vomit, so in this tasting area they can sort out any toxic plant and spit it out to the side, because once it's swallowed, it's a done deal.
Once they’re happy with what they’ve bitten off, they roll the forage into a food roll ('bolus') and here’s where the grinding of the forage takes place, to break down the forage stem wall and expose the inner forage fibre inside that the hindgut microbes will then break down to produce the horse's energy. Grind grind grind, until it’s all broken down ready to be swallowed. Chewing also creates saliva which adds moisture and mucus to the mix, as well as starting to regulate the pH level. Some interesting stats for you - to chew 1kg of hay takes up to 3,500 chewing motions over 40-50 minutes, and generates 3-5 litres of saliva!
And here’s where the fibre length is so important – the forage length needs to be 8cm or longer, or less than 5mm so it can be swallowed without chewing. If it’s in between the horse won’t chew it properly, so we risk unchewed fibres sitting in the hindgut for longer and fermenting, because the inner cellulose fibre won’t have been exposed by the teeth grinding the forage stem.
As I said, this is fine if the horse is foraging on growing grasses, but when it comes to chaffs or hay, we need to be mindful of the fibre length, hence why chaffs become questionable. So, we're looking for an optimal forage fibre length of around 8cm minimum - we've heard of dramatic improvements in health when clients have changed the hay length they source.
Once the chewing/grinding's done, we're ready to swallow and pass the bolus into the oesophagus. Think of the oesophagus as a garden hose, around 1.5-meters long in an average horse, but only around a tiny 1.5-cm wide, so all the food has to pass through a long and very narrow tube.
Digestion - it's all about the how
The chewed food now passes into the stomach/foregut to be broken down into a soupy mix (called 'chyme'), to then pass into the small intestine for the microbiome microbes to separate out the essential nutrients so they can be absorbed into the bloodstream to fuel the body. What's left at the end of the sorting process - forage/roughage fibre - gets shuttled off to the large intestine/hindgut for fermentation and energy production, with the resulting waste made up of 50% fibre fibre/50% micro-organisms, shifting on to the main elimination exit point and coming out in perfect parcels of poo 😉
The intestinal tube doesn't do all this by itself - the very function of the gut system relies entirely upon it's own army of elements. The horse's digestion operates via enzymes with most (over 50%) of the protein pre-digestion and most soluble carbohydrate pre-digestion happening in the stomach; fats are then broken down in the small intestine by bile, ahead of the hindgut, which is where we'll find the cecum and two colons, and this is where it's now about bacterial, aka microbial, fermentation of the fibre sources, i.e. grass, hay, woody fibres. And because our horses' energy comes from the hindgut fibre fermentation, keeping the microbiome, aka friendly bacteria/flora/biota, well-populated in the hindgut is right up there at the top of the list of priorities.
Horses normally consume 2-2.5% of their body weight in dry fibre matter each day, although if they’re on pasture 24/7 this can go up to over 3%. Remarkably, the capacity of the stomach of the horse is small, about the size of a rugby ball and coming in at just 8 to 15-litres depending on the horse-size. So, it begs the question as to how a horse can consume such large amounts of food/water when constantly grazing. Easy - the time it takes for food to transit from the stomach to the small intestine is anywhere between 2-6hrs, and it never empties - this is so important as so many equine health issues are caused through not enough forage when stabled and letting the stomach become empty.
As the horse continues to eat, the digesta trickles through into the small intestine, hence the term ‘trickle feeders’. The rate of passage through the small intestine is about 1ft/minute, with the average length in total of the small intestine being around a whopping 70-feet.
The foregut is the only part of the gut system that's acidic - once digesta moves into the small intestine and onwards, the gut needs a neutral pH - it's a huge problem if any part of the rest of the digestive system becomes acidic.
The stomach acid is there for a massively important reason, well, two actually - first off to kill off contamination that's come in on the forage, and secondly to activate the protein digestive enzyme, pepsinase, into pepsin. Another really important factor when it comes to the conventional veterinary treatment for ulcers where PPIs (proton pump inhibitors) are prescribed, aka Gastrogard/Omeprazole. PPIs are designed to switch off the acid production, but without the acid we risk contaminants entering the small intestine, and worse, impaired protein digestion. And when undigested protein gets into the hindgut, the horse is in real trouble. All covered in our Ulcer page.
The foregut as where the pre-digesting of the foodstuff happens, and it does it via 3-sections:
The first section, the pars nonglandularis, has a reasonably high pH, between 5-6, so not too acidic - there's no stomach acid in the front section of the foregut, but what we do have here is resident lactic-acid bacteria (LA), usually brought in by the horse ingesting it from their feed/forage. STOP PRESS!! Under normal circumstances the last thing we want in the intestines is lactic acid bacteria, but in this front section of the stomach it's expected, and the good news is that at least here in the front section of the foregut they also have a useful job to do (more on this throughout this chapter). These LA bacteria make lactic acid (LA) from eating starch and sugar in the feed - it's where they derive their energy from as they can't utilise plant fibres. So, when the horse has ingested starches, the lactic acid bacteria start pre-digesting the starch molecules which makes them easier for the small intestine to digest further on. Clever 😉 (PS - this is also the region where the horse experiences squamous ulcers, caused by inappropriate feed or when the stomach has been starved and allowed to empty).
Now to the middle section, and this is where the pepsinase enzyme, the protein digester, is produced. This then needs to be activated into pepsin by the stomach acid to perform the protein pre-digesting. This activation can only happen when the stomach pH drops to below 4, when the digesta hits the hydrochloric acid in the back section of the stomach.
The back section, pars glandularis, is where the hydrochloric acid sits - its role is basically to disinfects any nasties in the feed such as microbial contamination (it's how dogs survive eating other dogs' poop, as well as other revolting rotting foodstuffs, with their acid pH value a super-severe 1!); this is also where, as mentioned earlier, the protein digestive enzyme, pepsinase, is activated into pepsin, and can now start to degrade the proteins in the feed. Horses have a hydrochloric acid pH of around 3 - less harsh than a dog or cat - which reduces the level of microbial contamination in the feed, but not 100%. (PS - this is also the region where the horse experiences glandular, aka pyloric ulcers, caused by stress resulting in poor blood flow to produce the protective mucus layer on the mucosa membrane).
In summary, a normal foregut process is that :
a horse should have a constant uptake of roughage so that the stomach remains constantly full, active and operating
with a pre-digestion of starch via LA bacteria in the first section producing LA
pepsinase production in the middle section
the back section activating pepsinase to pepsin, alongside inactivation of any remaining lactic acid bacteria and microbial decontamination on the feed.
Once done, the pre-digested starches and proteins, along with all the fibre matter etc., are now ready to exit the stomach and head into the small intestine.
The rest of the journey
Once the digesta hits the small intestine, a bile trickle is released to digest the fats, while the small intestine's microbes assimilate the nutrients ready for absorption. Finally we get to the hindgut, where the fibre is fermented down by the hindgut's own friendly fermenting microbes, and this is where the horse's energy is produced. And all the while there have been fluids and mucus to lubricate and keep everything moving along the way as well.
Without these essential elements, the gut system won't be able to do the very job it's meant to do, which is to keep the body alive. Without them it won't be able to digest the food or supplements that we pay good money to keep our horses healthy. If digestion is impaired, so will begin a cascade of seriously chronic dis-ease.
This life-dependent function relies entirely on maintaining a healthy inner-gut environment, and the only way to do this is by feeding foods that feed the good bugs and starve the bad bugs - this is critical for maintaining that healthy inner environment and preventing SIBO - small intestinal bacterial overload - and leaky gut syndrome, which these days is now so widespread amongst our equines, so much so that it's now considered an epidemic.
So, if you're looking to clear up the chronic symptoms that are chipping away at your horse's quality of life, there's only way to do it - feed a constant supply of quality, high-fibre, grass forage and roughage - barks, woods and roots. We need to look after our horse's gut health first and foremost, as the top priority. This applies as much to humans as horses too, although obviously we're not going to start eating hay 😉
NB. The foal and growing horse have undeveloped cecal and colonic digestion compared to the adult horse. There is very little microbial digestion before 3 months of age, so the foal requires a diet low in fibre and one that is easily digested in the foregut. Foals who are seen eating their mothers' droppings are thought to be obtaining a bacterial culture necessary for future microbial digestion, so if you see this happening, encourage it!
A quick intro to the all-important Microbiome, the body's 2nd Brain
Collectively the beneficial and pathogenic microbes outnumber the regular cells in the whole, entire body, by an astonishing 10-1 - at least (!). Think about that for a second - there are a whopping 10-times more bugs in the gut system, that long tube from mouth to the final exit point, than in the whole of the rest of the physical body. Which means if the microbiome gets disrupted, we're in a whole lot of trouble. So, looking after our horse's gut microbiome by feeding it what it needs - course, stemmy, cellulose-rich fibrous hay - is crucial, as amongst it's many vital roles, it's also the first line of defence against many serious diseases.
For starters, without a healthy microbiome, there's no nutrient absorption, crucial to fuel a healthy body. But it's so much bigger than this - the microbiome literally runs the show. Over 70% of our horse's immune cells are created by the gut microbes in the intestinal tract and these microbes are also the major regulator of the immune system - the difference between healthy and unhealthy relies entirely upon the gut microbiome's performance.
Unfortunately, there are certain medical treatments which can really mess with the gut ecology, such as antibiotics, bute, PPIs and chemical wormers, which disrupt the relationship in a similar way that chemotherapy affects the human body. Chemotherapy wipes out perfectly healthy non-cancerous cells inside the human body along with the cancerous cells, annihilating the immune system. Similarly, antibiotics completely wipe out the gut bacteria, the bad bugs as well as the good bugs the body can’t live without.
A healthy gut system is essential for overall health and vitality - sounds obvious I know but an effective digestive process means your horse will absorb the nutrients you spend a fortune on trying to get into them. Again, it's still a much bigger picture; a healthy microbiome will also significantly minimise the laminitis/colic risk, and protect the horse against infections such as diarrhoea-causing organisms like salmonella or clostridium.
The good news is that a healthy, functioning digestive system is really straightforward to manage - it really is, provided we feed them the right stuff, as in the food that their gut is meant to eat. Because ... the equine digestive system is also extremely sensitive, and it doesn't take much to upset the delicate gut ecology and environment; poor diet/dietary management, obviously, but chronic stress can equally play an enormous part in affecting gut health. Poor gut health can manifest itself in so many ways, from the obvious signs of loose droppings, lack of overall vitality, allergies or pain.
For the full story on how critical a part the microbiome plays in overall health, see our separate chapter - The Microbiome - the Missing Organ? I promise you it's an eye-opening read ...
Dysbiosis/SIBO/Leaky gut syndrome
“Dysbiosis (also called dysbacteriosis) is a term for a microbial imbalance or maladaptation on or inside the body, such as an impaired microbiota.” Wiki
In other words, microbiome dysbiosis is when that very fragile microbe balance within the gut microbiome environment is disrupted and the biome/microbe ratios are not what they're supposed to be anymore.
The lining of the gut's small intestine is supposed to be strong and tight, keeping food, microbes and waste safely inside the digestive tract. So why is 'leaky gut syndrome' now becoming a new epidemic?
As above, I can't stress enough how important it is to centre our attention on the microbiome, and specifically those beneficial gut microbes, to avoid dysbiosis. Another fact - it's the microbiome, as in a healthy one, filled with lots of happy, beneficial microbes busying away down there sorting out the nutrients and fermenting the fibre in the hindgut , that regulates the permeability, aka leakiness, of the gut wall lining - this is the connecting factor.
When the gut bacteria balance is disrupted and the balance between the friendly microbes and pro-inflammatory toxic microbes reverses, those bad microbes set up camp and create inflammation. This is known as SIBO - Small Intestinal Bacterial Overgrowth, and SIBO isn't funny. For starters, the inflammation then disrupts the tight junctions of the gut wall which makes it permeable, as in leaky, and allows the undigested, seriously toxic waste in the small intestine to leak through the gut and into the bloodstream, literally poisoning it. This triggers an almighty inflammatory autoimmune cascade as the immune system goes into hyper-overdrive, trying to fight those leaked toxins.
Cue the battlefield. Special antibodies, aka immunoglobulins, live in the horse's gut to protect the body. The immunoglobulins IgA and IgM help identify the toxins, and begin the attack by calling in the regiments of killer-army white blood cells. The more overwhelming the leaked toxin burden is, the longer the battle and the greater the inflammation, not to mention red-hot pain.
Be under no illusion - leaky gut affects the whole process for just about every medical condition, be it joint, skin, brain - hooves especially as leaky gut causes laminitis. Everything depends on the integrity of that gut wall membrane, which astonishingly is a mere 1-cell thick, so you can appreciate just how vulnerable the gut lining is.
Vaccines don't help either, as vaccines can contain proteins and other food particulates. This is because manufacturers use cells from animals, like chicken embryo and bovine serum, to grow the antigen. When the antigen finishes growing, it's separated from the proteins, but sometimes small amounts still end up in the vaccine. During vaccination, these food proteins and other components get introduced into the body.
Cue yet another exaggerated immune response. All these components are identified as enemies, and when any enemy shows its ugly face, it’s time for battle.
These days we have the knowledge and the tools to get the diet right - forage/roughage fibre all the way - which nurtures the biota to flourish, in order to maintain its production of the important nutrients - which include producing the B-vits and several amino acids - that the body needs to be healthy. This is a whole separate chapter in itself - see our Feeding our Horses section, and specifically the Why what we feed has to be right page.
For the full story on leaky gut, see our separate chapter - Leaky Gut - a Growing Epidemic. For the latest updates on SIBO, see our Blog Post - SIBO – another case of ‘everything’s connected’
Any metabolic gut disturbances, i.e. diarrhoea/faecal water, are all signs of dysbiosis in the hindgut so there could very well also be something leaky going on as well..
Coarse stemmy hay is going to be your saviour here – absolutely not haylage as this creates lactic acid in the hindgut, nor grass as this is too leafy, no fibre, and full of pectins which also create lactic acid in the hindgut. With a horse being nothing more, and nothing less, than a hindgut fibre fermenter, we need to get those all-important forage plant fibres, cellulose and hemicellulose, found only in long, dry, growing grasses or in stemmy hay, back into the hindgut to rebalance the biome, so if you're feeding hay try not to go for an early cut as this will have been cut from grass blades only, no stems, which are high in pectins – we need a late-only cut where the grass has flourished enough to seed, so there’s lots of stem full of cellulose.
Also, many essential nutrients are produced by the hindgut biome, including the B-vits and many amino acids, so with diarrhoea there there’s every chance that there’s now a B-vit and amino-acid deficiency. Feeding hay will help get things back on track but it might be worth giving a B-vit and Essential Amino Acids supplement for a while until the hindgut’s happier again. We have both these supplements available in our Individual Items/Nutrients shop page.
- when we refer to ulcers, we're talking foregut ulcers. Hindgut 'ulcers' is a completely different thing; for starters they don't exist - they're a myth - because there are no acid-secreting cells in the hindgut. There is, however, Hindgut Acidosis, caused by lactic-acid being produced in the hindgut by lactic-acid bacteria. If you've been told your horse has hindgut 'ulcers', see our separate Hindgut Acidosis chapter (link also at the bottom of this page).
Here’s a thing – foregut ulcers are there because the gut environment has been already altered, usually due to either some form of stress, pharma meds, or inappropriate feed. These factors are the cause of why our horses – and us humans – get ulcers. Stress, pharma meds and/or poor quality feed destroy the gut environment, literally, which means that without a strong, healthy protective mucosal gut lining, the stomach acid will splash onto the mucosa and create an ulcerated sore, because it’s almighty strong hydrochloric acid, same as a car battery.
Sounds simple enough doesn’t it. Yet most of us have no idea how many vital roles the stomach acid plays in the body, whether horse or human, and ... the drug companies know it too. You can’t watch TV without seeing an advert for some chalky tablet to ‘calm’ the acid burn, especially after we've eaten a red hot curry.
The claim that the acid is causing the ulcers is a myth. The acid splash/leak is merely a knock-on effect of the initial cause which has caused the damage in the gut.
Top TIps :
Remove the stressors which are stressing your horse.
Refocus on your training/discipline - considerate short bursts to allow your horse to process what you're trying to communicate.
Make sure there’s continuous ad-lib hay.
Let a horse be a horse, allowed to express their natural behaviour with freedom, buddies and social interaction - as the saying goes, 'Friends, Forage, Freedom'.
This isn't complicated - it's straightforward horsecare. Sadly we inherit a lot of damage when we take on a new horse so there's often a lot of unravelling and unpicking to do, but if you remind yourself that a horse is a horse (and not a cow, human or robot), and factor specific horse needs into your care, you'll very likely witness a remarkably quick, not to mention a safe and natural recovery, without having to shovel damaging drugs (Proton Pump Inhibitors, aka PPIs) which have horrible side-effects, into our horses' already altered - and damaged - digestive systems.
Meanwhile, see our dedicated Ulcers page, link also below, for the full story on PPIs.
Probiotics and Prebiotics
Despite the similarity in their names, pro-biotics and pre-biotics are not different forms of the same - they're very different, and each have unique mechanisms of action on the gut.
are a live-bacteria supplement added into the diet to promote the colonisation of the beneficial microbes, usually recommended to be added to the diet for a short while
after gut illness such as faecal water syndrome/colic/diarrhoea, or after a gut-damaging course of antibiotics or a chemical wormer. Although probiotics have been around for many years, research on the topic is still in its infancy. They should be thought of as an occasional 'support', and not fed on an ongoing basis, as the health and diversity of the biome relies on species-appropriate food, as in appropriate fibre for the hindgut fibre-fermenting microbes. If you need to feed a probiotic, we sell Alltech's Yea-Sacc
- a Saccharomyces cerevisiae
strain - either separately in our Individual Items
section so you can add it independently to the feedbowl, or in our EquiVita/VitaComplete
'ProB' range of mineral balancers where we include the 10g RDA.
Prebiotics are a natural food source that feed those beneficial microbes, stimulating the microbiome's growth and activity. We really don't need to add any supplement advertised as a prebiotic because the best source is - you've guessed it - cellulose fibre, from long, coarse, stemmy, cellulose-rich hay, preferably cut from a diverse range of meadow grasses. If you look at products sold specifically as ‘prebiotics’, i.e. inulin, you’ll see they’re based on pectins, which we definitely want to avoid as pectins create lactic-acid in the hindgut and lower the pH value, turning the hindgut environment acidic. It's exactly the same in the human world - plant/vegetable fibre is our finest prebiotic to feed our own gut flora, so eat your greens, chop up an onion and grate yourself a carrot 😉
Updated Spring 2021 - The latest science is now saying that we don't need to feed a probiotic all the time, only when the gut's been disrupted as mentioned above. There's also the fact that all the available products on the market aren't necessarily appropriate for the fragile equine gut ecology - currently there’s no probiotic available that mimics the microbiome of the horse.
It's also not so much about what type of microorganism – it’s all about diversity. Remember, the whole microbiome - the very eco-system of all the trillions of bacteria bugs in the gut system - outnumber the body’s cells by 10-1; they also outnumber DNA cells by a whopping 100-1 (we really are more bug than organism!), so the current thinking is now saying that adding in just one type of microbe could well disrupt this fragile ecology.
General pointers for a healthy gut system
Horses are herbivores which evolution has designed to graze on a diverse range of high fibrous, low-energy forages up to at least 20 hours per day - in the perfect world this forage should consist of multiple diverse grasses, plants, barks, roots etc., to create a diverse microbiome.
Here In the UK the best feed your horse can put in his mouth is hay, grass in its dried form. The bulk delivered by a fibrous hay diet is a key weapon in avoiding colic because consistent gut-fill maintains a continuous level of digestive activity.
Allowing your horse's stomach to become empty is one of the biggest causes of stomach ulcers, so always make sure hay is fed ad-lib - don't ever ration it.
Additionally, the more horses chew, the more saliva is generated and mixed in with the mouthful of hay, which helps buffer GI tract acidity.
Definitely don't feed haylage
(high lactic-acid %).
Unfortunately, domesticated living usually challenges the horse's sensitive digestive tract with inappropriate ultra-processed feedstuffs
, irregular feeding schedules and ration portions that are far outside the norm of the natural plan. One of the primary reasons that horses colic is the difference between what the digestive system is meant to process and what it actually gets.
Avoid any sweet feeds (Musli's/Beet
) - it's what the pro-inflammatory gut microbes gorge on which causes them to multiply and kill off the beneficial microbes that do all the good stuff like digestion.
Keep your horse moving – stabled horses are much more prone to gut issues than those who live out. Turnout with companions keeps horses happy, allows them social interaction and lets them eat their favourite food. Not only is the horse free to consume the ideal fibrous diet, but the simple, continual act of moving to eat, enhances motility of keeping the food moving along in the gut.
To promote healing of the gut, this is where the right kind of gut microbe
comes into play. The right kind of microbe will break down fibre in the diet into molecules that are really easily used by the gut cells as energy sources. So, other than making sure our horse has plenty of fibre and the right kind of microbe in the gut to heal the gut, there are two essential amino acids you can use, especially if you're dealing with gastric ulcers or leaky gut. N-Acetyl L-Cysteine (NAC)
, the precursor to glutathione (arguably the most powerful antioxidant in the body) replenishes glutathione production; Glutamine
is a building block for proteins that maintain cellular health and tissue repair. During critical illness, trauma, intestinal disease, excessive loss of lean body mass, and extreme endurance exercise, Glutamine is shown to be beneficial. Glutamine also works in synergy with NAC to help promote glutathione. We've blended both these amino acids together as a gut support in our GutAminos
Aloe vera juice is a beneficial gut supporter. It's high in digestible fibre which gives it the properties of lowering bowel transit time, supporting hindgut bacteria and soothing the digestive tract overall. Aloe also contains a complex mixture of mucopolysaccharides (complex sugars) that nourish cells and support them in replicating. Aloe juice is also especially important for gut acid; its polysaccharides can be helpful for horses who have been on buffering agents that destroy the healthy bacterial populations in the gut and thus allow pathogenic bacteria to multiply. Good quality aloe juice can be found in most health food stores - add 50-100ml to feed when your horse is displaying symptoms.
Slippery Elm v Marshmallow Root
Slippery Elm is a renowned gut-healing herb with similar properties to Aloe. However, the native populations of the slippery elm tree are suffering due to its worldwide popularity and the tree is now considered extremely rare, which occasionally makes it tricky to source; as a result it's now a protected species which is reflected in its price - slippery elm isn't cheap! The good news is that marshmallow root can be suitably substituted for slippery elm because marshmallow has almost identical properties and is so much more widely available - and a tad cheaper too! Marshmallow root has a higher mucilage % than the leaf so is the better one to go for for gut soothing, with the leaf more indicated for respiratory tract soothing. Add 50ml Aloe and 1-desertspoon of marshmallow to feed.
Aloe and Marshmallow are not only beneficial for digestion in general but also support excess gut acidity as well. They can both be fed long term with no negative effects.
Apple Cider Vinegar is also invaluable for gut health - not only is it a beneficial supporter of immunity, it's also rich in natural probiotics, beneficial enzymes and acids that help absorption of nutrients.