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Slippery Elm

What is it?

Slippery elm is a tree that is native to eastern Canada and the eastern and central United States. Its name refers to the slippery feeling of the inner bark when it is chewed or mixed with water. The inner bark (not the whole bark) is used as medicine.

People take slippery elm by mouth for coughs, sore throat, colic, diarrhea, constipation, hemorrhoids, irritable bowel syndrome (IBS), bladder and urinary tract infections and inflammation, syphilis, herpes, and for expelling tapeworms. It is also used for protecting against stomach and duodenal ulcers, for colitis, diverticulitis, gastrointestinal inflammation, and too much stomach acid. Slippery elm is also taken by mouth to cause an abortion and for cancer.

Slippery elm is applied to the skin for wounds, burns, gout, rheumatism, cold sores, boils, abscesses, ulcers, toothaches, sore throat, and as a lubricant to ease labor.

In manufacturing, slippery elm is used in some baby foods and adult nutritionals, and in some oral lozenges used for soothing throat pain.

How effective is it?

Natural Medicines Comprehensive Database rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, Ineffective, and Insufficient Evidence to Rate.

The effectiveness ratings for SLIPPERY ELM are as follows:

Possibly effective for...

  • Sore throat. Slippery elm seems to soothe sore throats. Commercial lozenges containing slippery elm are preferred to the native herb when used for this condition. The lozenges prolong the pain-killing effect.

Insufficient evidence to rate effectiveness for...

  • Cancer. Early research suggests that a specific product containing burdock root, Indian rhubarb, sheep sorrel, and slippery elm bark (Essiac, Resperin Canada Limited) does not improve quality of life in breast cancer patients.
  • Irritable bowel syndrome (IBS). Early research suggests that taking a specific product containing slippery elm bark, lactulose, oat bran, and licorice root can increase bowel movements and reduce stomach pain and bloating in people with IBS that is characterized by constipation. A different combination product containing slippery elm bark, bilberry, cinnamon, and agrimony can reduce stomach pain, bloating, and gas in people with IBS that is characterized by diarrhea. The effects of taking slippery elm bark alone are not clear.
  • Bladder infection.
  • Burns and wounds.
  • Coughs.
  • Colic.
  • Constipation.
  • Diarrhea.
  • Gout.
  • Hemorrhoids.
  • Herpes.
  • Rheumatism.
  • Stomach ulcers.
  • Syphilis.
  • Tapeworm.
  • Toothache.
  • Urinary tract infections.
  • Other conditions.
More evidence is needed to rate the effectiveness of slippery elm for these uses.

How does it work?

Slippery elm contains chemicals that can help soothe sore throats. It can also cause mucous secretion which might be helpful for stomach and intestinal problems.

Are there safety concerns?

Slippery elm is POSSIBLY SAFE for most people when taken by mouth appropriately. There is insufficient reliable information available about the safety of slippery elm when applied to the skin. In some people, slippery elm can cause allergic reactions and skin irritation when applied to the skin.

Special precautions & warnings:

Pregnancy and breast-feeding: Folklore says that slippery elm bark can cause a miscarriage when it is inserted into the cervix of a pregnant woman. Over the years, slippery elm got the reputation of being capable of causing an abortion even when taken by mouth. However, there's no reliable information to confirm this claim. Nevertheless, stay on the safe side and don't take slippery elm if you are pregnant or breast-feeding.

Are there interactions with medications?

Moderate
Be cautious with this combination.
Medications taken by mouth (Oral drugs)
Slippery elm contains a type of soft fiber called mucilage. Mucilage can decrease how much medicine the body absorbs. Taking slippery elm at the same time you take medications by mouth can decrease the effectiveness of your medication. To prevent this interaction, take slippery elm at least one hour after medications you take by mouth.

Are there interactions with herbs and supplements?

There are no known interactions with herbs and supplements.

Are there interactions with foods?

There are no known interactions with foods.

What dose is used?

The appropriate dose of slippery elm depends on several factors such as the user's age, health, and several other conditions. At this time there is not enough scientific information to determine an appropriate range of doses for slippery elm. Keep in mind that natural products are not always necessarily safe and dosages can be important. Be sure to follow relevant directions on product labels and consult your pharmacist or physician or other healthcare professional before using.

Other names

Indian Elm, Moose Elm, Olmo Americano, Orme, Orme Gras, Orme Rouge, Orme Roux, Red Elm, Sweet Elm, Ulmus fulva, Ulmus rubra.

Methodology

To learn more about how this article was written, please see the Natural Medicines Comprehensive Database methodology.

References

  1. Zalapa JE, Brunet J, Guries RP. Isolation and characterization of microsatellite markers for red elm (Ulmus rubra Muhl.) and cross-species amplification with Siberian elm (Ulmus pumila L.). Mol Ecol Resour. 2008 Jan;8:109-12. View abstract.
  2. Monji AB, Zolfonoun E, Ahmadi SJ. Application of water extract of slippery elm tree leaves as a natural reagent for selective spectrophotometric determination of trace amounts of molybdenum(VI) in environmental water samples. Tox Environ Chem. 2009;91:1229-1235.
  3. Czarnecki D, Nixon R, Bekhor P, and et al. Delayed prolonged contact urticaria from the elm tree. Contact Dermatitis 1993;28:196-197.
  4. Zick, S. M., Sen, A., Feng, Y., Green, J., Olatunde, S., and Boon, H. Trial of Essiac to ascertain its effect in women with breast cancer (TEA-BC). J Altern Complement Med 2006;12:971-980. View abstract.
  5. Hawrelak, J. A. and Myers, S. P. Effects of two natural medicine formulations on irritable bowel syndrome symptoms: a pilot study. J Altern Complement Med 2010;16:1065-1071. View abstract.
  6. Pierce A. The American Pharmaceutical Association Practical Guide to Natural Medicines. New York: The Stonesong Press, 1999:19.
  7. Robbers JE, Tyler VE. Tyler's Herbs of Choice: The Therapeutic Use of Phytomedicinals. New York, NY: The Haworth Herbal Press, 1999.
  8. Covington TR, et al. Handbook of Nonprescription Drugs. 11th ed. Washington, DC: American Pharmaceutical Association, 1996.
  9. Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
  10. Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 1st ed. Montvale, NJ: Medical Economics Company, Inc., 1998.
  11. McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
  12. The Review of Natural Products by Facts and Comparisons. St. Louis, MO: Wolters Kluwer Co., 1999.
  13. Newall CA, Anderson LA, Philpson JD. Herbal Medicine: A Guide for Healthcare Professionals. London, UK: The Pharmaceutical Press, 1996.
  14. Tyler VE. Herbs of Choice. Binghamton, NY: Pharmaceutical Products Press, 1994.
Last reviewed - 06/29/2016