slippery elm

Slippery elm is a tree (Ulmus fulva, Ulmus rubra) native to North America. For centuries, indigenous people of America have been taking slippery elm orally to treat various ailments including cough, sore throat, and gastrointestinal (GI) conditions, and used topically as a salve to heal wounds, ulcers, boils, burns, and skin inflammation. Slippery elm may be effective for soothing sore throat, however, there is little research on its efficacy for other conditions.

The name slippery elm comes from the slippery feel of the tree’s inner bark when chewed or mixed with water. The inner bark is the part used for medicinal purposes, after it is dried, powdered, and mixed with water. Slippery elm contains mucilage, a type of soluble fiber that forms a gel-like substance when dissolved in water.

The slippery elm mucilage coats the lining of the throat and GI tract and soothes irritation, and stimulates the GI nerve endings leading to increased mucus secretion which may help with stomach ulcers and acidity. The mucilage has antioxidant properties which may help reduce inflammation in the GI tract when taken orally or on the skin when applied topically.

Slippery elm is available as tablets and capsules, lozenges, finely powdered bark for making teas or extracts, and coarsely powdered bark for poultices. Some baby food products and nutrition drinks may also contain slippery elm. The suggested uses of slippery elm include:

Oral

• Sore throat
• Cough
• Constipation
• Irritable bowel syndrome
• Ulcer prevention
• Diarrhea
• Inflammatory bowel conditions such as colitis, diverticulitis, and Crohn’s disease
• Gastroesophageal reflux disease (GERD)
• Bladder inflammation (cystitis) and urinary tract infections

Topical

• Wounds, skin ulcers, burns, and skin inflammation
• Cold sores, boils, and abscesses
• Toothaches
• Gout and rheumatism
• Lubricant to ease labor

• Do not use slippery elm if you are hypersensitive to pollen
• Do not use during pregnancy, may cause miscarriage.
• Take slippery elm 2 hours before or after you take other medications. It coats the lining of the GI tract and may interfere with the absorption of other medications.

Common side effects of slippery elm include:

• Allergic reaction
• Contact dermatitis
• Miscarriage in pregnant women

This is not a complete list of all side effects or adverse reactions that may occur from the use of this drug.

Call your doctor for medical advice about serious side effects or adverse reactions. You may also report side effects or health problems to the FDA at 1-800-FDA-1088.

There isn't enough reliable information to know what might be an appropriate dose of slippery elm. Natural products are not always necessarily safe and dosages can be important. Follow directions on product labels and consult a healthcare professional before using.

Suggested Dosing

Powdered Inner Bark (1:8 decoction)

• 4-16 ml orally three times daily

Powdered Inner Bark (nutritional supplement)

• 4 g/500 ml water orally three times daily

Liquid Extract

• 5 ml orally three times daily; 1:1 in 60% alcohol

Poultice

• Apply topically; mix coarse powdered inner bark with boiling water

• Slippery elm is not known to have serious adverse effects and there is no information available on slippery elm overdose.
• In case of overdose, seek medical help or contact Poison Control.

Inform your doctor of all medications you are currently taking, who can advise you on any possible drug interactions. Never begin taking, suddenly discontinue, or change the dosage of any medication without your doctor’s recommendation.

• Slippery elm has no known severe, serious, moderate or mild interactions with other drugs.

The drug interactions listed above are not all of the possible interactions or adverse effects. For more information on drug interactions, visit the RxList Drug Interaction Checker.

It is important to always tell your doctor, pharmacist, or health care provider of all prescription and over-the-counter medications you use, as well as the dosage for each, and keep a list of the information.

Check with your doctor or health care provider if you have any questions about the medication.

• Slippery elm may cause miscarriage, although it is not clear whether from taking orally or insertion of the bark into the cervix during pregnancy. Avoid taking slippery elm while pregnant.
• There is no information on the safety of slippery elm use by nursing mothers. Avoid taking slippery elm if you are breastfeeding.

• Slippery elm is possibly safe for most people.
• Do not take a higher dose than what is recommended on the label.
• Always check labels of herbal supplements for the ingredients they contain.
• Slippery elm is marketed as an herbal supplement and does not require extensive pre-marketing approval from the FDA. There may be discrepancy between the labeling and the actual ingredients and their amounts. Choose your product carefully.