Sand Enteropathy-What We Know So Far and Why There Is Still So Much to Learn

Sand enteropathy describes pathophysiological conditions of the equine gastrointestinal tract due to the uptake and accumulation of sand. It is an increasingly recognized cause of gastrointestinal disease in arid geographic areas. Clinical signs can vary widely from colic, fever and inappetence to poor performance. Diagnosis based solely on clinical signs is nearly impossible. The current literature describes a variety of diagnostic aids, with radiographic imaging considered the gold standard. Therapeutic approaches aim at the evacuation of sand from the abdomen. This can be achieved by the administration of psyllium in connection with a laxative via nasogastric intubation. Several studies describe varying laxatives such as mineral oil or sodium-/magnesium sulphate. This narrative review includes 39 publications up to the year 2026. We aim to raise awareness among practicing veterinarians and highlight new research objectives to improve knowledge and treatment of gastrointestinal diseases related to sand accumulation.