slippery elm

Action and Spectrum

Actions and Spectrum: 

slippery elm (Ulmus rubra) inner bark of the tree has been used for various medicinal purposes, including traditional herbal medicine.  

• Mucilage Content: It contains a high concentration of mucilage, that can absorb water and become slippery. This mucilage is believed to coat and soothe the mucous membranes, including the digestive tract. 
• Demulcent Properties: The mucilage in slippery elm is thought to have demulcent properties, meaning it may form a protective layer on irritated or inflamed tissues. This could provide relief from conditions such as sore throat, cough, or gastrointestinal discomfort. 
• Gastrointestinal Soothing: slippery elm has traditionally been used to soothe the gastrointestinal tract. Its mucilage may provide a protective barrier on the tract’s lining, helping with conditions such as heartburn, gastritis, and inflammatory bowel disease. 
• Throat and Respiratory Health: Due to its mucilage content, slippery elm has been used to alleviate throat irritation and cough. It is sometimes included in throat lozenges or teas for respiratory support. 
• Anti-Inflammatory Potential: Some studies suggest that slippery elm may have anti-inflammatory properties, which could contribute to its soothing effects on mucous membranes.  
• Wound Healing: slippery elm mucilage has been used externally, such as in poultices, for wound healing. The mucilage may soothe the skin and help promote healing. 

Drug Interaction

Adverse Reaction

Frequency not defined 

Allergic reaction 

Contact dermatitis 

Abortifacient (whole bark) 

Black Box Warning

Black box warning: 

None 

Contraindication / Caution

Contraindications/caution: 

Contraindications: 

Pregnancy 

Hypersensitivity to pollen 

Caution: 

• Allergic Reactions: Individuals with known allergies to elm products should exercise caution when using slippery elm. Allergic reactions could include skin rash, itching, swelling, or difficulty breathing. 
• Gastrointestinal Blockage: In rare cases, there have been reports of gastrointestinal blockage associated with the use of slippery elm. This is more likely to occur if the herb is not taken with sufficient water. 

Pregnancy / Lactation

Pregnancy consideration: It has the property of inducing abortion; precaution has to be taken as it is  extremely dangerous and is associated with serious health risks 

Lactation: Excretion of the drug in human breast milk is unknown 

Pregnancy category: 

Category A: well-controlled and Satisfactory studies show no risk to the fetus in the first or later trimester. 

Category B: there was no evidence of risk to the fetus in animal studies, and there were not enough studies on pregnant women. 

Category C: there was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women.    

Category D: adequate data with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits.    

Category X: Drugs listed in this category outweigh the risks over benefits. Hence these categories of drugs need to be avoided by pregnant women.    

Category N: There is no data available for the drug under this category 

Pharmacology

Pharmacology: 

The pharmacology of slippery elm (Ulmus rubra) is primarily associated with its traditional uses in herbal medicine. 

• Mucilage Content: slippery elm bark contains a high concentration of mucilage, a gel-like substance that can absorb water and become slippery. This mucilage is believed to coat and soothe the mucous membranes, including the digestive tract. 
• Demulcent Properties: The mucilage in slippery elm is thought to have demulcent properties, meaning it may form a protective layer on irritated or inflamed tissues. This could provide relief from conditions such as sore throat, cough, or gastrointestinal discomfort. 
• Gastrointestinal Soothing: slippery elm has traditionally been used to soothe the gastrointestinal tract. Its mucilage may provide a protective barrier on the tract’s lining, helping with conditions such as heartburn, gastritis, and inflammatory bowel disease. 
• Throat and Respiratory Health: Due to its mucilage content, slippery elm has been used to alleviate throat irritation and cough. It is sometimes included in throat lozenges or teas for respiratory support. 
• Anti-Inflammatory Potential: Some studies suggest that slippery elm may have anti-inflammatory properties, which could contribute to its soothing effects on mucous membranes.  

Pharmacokinetics: 

Absorption 

slippery elm is typically administered orally, and its mucilage content is believed to be responsible for its demulcent properties. The mucilage forms a gel-like substance when mixed with water, and it is thought to coat and soothe the mucous membranes of the gastrointestinal tract. However, the extent and rate of absorption of specific constituents from slippery elm need to be better characterized. 

Distribution 

After absorption, slippery elm’s components, such as mucilage, may be distributed throughout the body. The mucilage’s demulcent properties may provide a protective coating on mucous membranes in various tissues. 

Metabolism 

Specific details about the metabolism of slippery elm constituents are not well-established. Herbal products can contain various compounds, and the metabolism of these compounds may vary. Some components may undergo metabolism in the liver or other tissues. 

Elimination and Excretion 

slippery elm constituents, including metabolites, may be excreted from the body through various routes. The kidneys are the primary route for the elimination of water-soluble compounds, and other pathways may include bile and feces. 

Adminstartion

Administration: 

Oral administration 

• Powder or Capsules: slippery elm is often available in powdered form or as capsules. In this form, it can be taken orally with water. The powder can be mixed with water to create a mucilage, and it is usually consumed before meals. 
• Tea or infusion: slippery elm bark can be prepared as a tea or infusion. To make slippery elm tea, the powdered bark or bark chips are steeped in hot water for 30 minutes. The mixture is then strained, and the liquid is consumed. This form is often used for its demulcent properties to soothe the digestive tract. 
• Poultice: Externally, slippery elm bark can be used to make a poultice. The powder or a gel made from the inner bark is applied topically to the skin for wound healing and soothing purposes. 
• Extracts and Tinctures: Liquid extracts and tinctures of slippery elm are also available. These are concentrated forms of the herb and can be added to water or another liquid before ingestion. 

Patient Information Leaflet

Patient information leaflet 

Generic Name: slippery elm 

Why do we use slippery elm? 

slippery elm (Ulmus rubra) has a history of traditional use in herbal medicine, primarily for its mucilaginous properties. Here are some of the traditional uses of slippery elm: 

• Sore Throat and Cough: slippery elm is often used to soothe sore throats and alleviate coughs. Lozenges or teas made from slippery elm may be employed for their demulcent properties, forming a protective coating on the throat. 
• Gastrointestinal Health: slippery elm has traditionally been used to support gastrointestinal health. Its mucilage content is believed to soothe the digestive tract, potentially alleviating conditions such as heartburn, gastritis, and inflammatory bowel conditions. 
• Wound Healing: slippery elm poultices have been used for wound healing. The mucilage may have emollient properties, supporting healing and providing relief to irritated skin. 
• Respiratory Support: In addition to soothing sore throats, slippery elm may provide respiratory support. It can be consumed as a tea or lozenge to help ease respiratory discomfort. 
• Skin Conditions: slippery elm’s mucilaginous properties may benefit certain skin conditions. Poultices or creams made from slippery elm may be applied topically to soothe irritated or inflamed skin. 
• Cough Syrups and Lozenges: slippery elm is sometimes used as an ingredient in cough syrups and lozenges, particularly those formulated to provide throat relief.