Slippery Elm

What Is Slippery Elm?

Slippery elm is one of the best digestive demulcents around.

The inner bark of slippery elm is used as a nutritious gruel or topically as a poultice. The mucilage soothes and nourishes the mucous membranes, speeds wound healing and lowers pain — making it an excellent candidate for lower digestive tract disorders.

The mucilage content of slippery elm is also useful topically on the skin. This herb makes for a great poultice for inflamed, damaged, or irritated skin. The nutritious powder is placed in water to expand and become a thick paste, which is then applied to the surface of the skin and wrapped in a cloth or towel.

Slippery elm can be bought in bulk and made into topical poultices, mixed into a paste for a nutritious gruel, added to shakes, or bought pre-capsulated and taken that way. This is a great herb to keep around the house for its broad range of uses on inflammation and irritation.

What Is Slippery Elm Used For?

Slippery elm is mainly used for its demulcent and emollient activities to soothe the digestive, respiratory, and integumentary tissues.

Internally slippery elm is used for conditions including colitis, peptic, and duodenal ulcers, diarrhea, gastritis, IBD, and any condition involving inflammation in the digestive tract.

Topically, slippery elm is used to treat inflamed or irritated skin, burns, boils, and abscesses, or wounds.

Contraindications

May reduce the absorption of other herbs, nutrients, and medications.

Traditional Uses

The slippery elm inner bark is an official drug of the United States official pharmacopeia, where it’s listed as a demulcent, emollient, and antitussive ^{3,4Reference 3Ulbricht C.E · 2005Natural standard herb and supplement referenceReference 4A Modern Herbal · 1931Slippery ElmView study →}. It was a popular Native American remedy that was quickly adopted by European settlers. In the American Civil War, it was commonly used as an effective wound healer among the soldiers ^{2Reference 2Braun et al. · 2010Herbs & natural supplements: An evidence-based guide Vol}.

Slippery elm inner bark powder was considered one of the best possible poultices for wounds and boils and all inflamed surfaces by the native American Indians ^{2,4Reference 2Braun et al. · 2010Herbs & natural supplements: An evidence-based guide VolReference 4A Modern Herbal · 1931Slippery ElmView study →}.

Slippery elm has been used traditionally to treat conditions affecting the digestive tract in much the same way that it’s used today. Additionally, this herb has been used to treat vaginitis, mouth inflammation, hemorrhoids, anal fissures, varicose ulcers, abscesses, carbuncles, and various skin conditions ^{2,5Reference 2Braun et al. · 2010Herbs & natural supplements: An evidence-based guide VolReference 5Hoffmann · 2003Medical herbalism: The science and practice of herbal medicine}.

Botanical Information

Slippery elm is a member of the Ulmaceae family of plants, also known as the Elm family, which all have characteristically mucilaginous bark and leaves. This family contains only 7 genera and about 45 different species.

Habitat, Ecology & Distribution

Ulmus rubra, otherwise known as red elm or slippery elm, is native to the eastern portions of North America, but can also be found growing in select areas of North America.

Slippery elm prefers dry, intermediate soils. ^{6Reference 6US Forest Service · 2016US Forest Service. (n.d.). Ulmus rubra. Retrieved August 2, 2016, from http://www.fs.fed.us/database/feis/plants/tree/ulmrub/all.htmlView study →}.

Harvesting, Collection & Preparation

It’s generally recommended that 10-year-old bark is used ^{4Reference 4A Modern Herbal · 1931Slippery ElmView study →}.

The mucilage cannot be extracted by alcohol and only swells in water rather than dissolving into it ^{4Reference 4A Modern Herbal · 1931Slippery ElmView study →}.

The most common method of consuming slippery elm for nutritive purposes is to make a gruel, similar in texture to oatmeal. This can be made by mixing about 5 ml of slippery elm powder with cold water to make a paste. Boiling water is then added to the desired consistency, and can be flavored with sugar, honey, or spices such as cinnamon or nutmeg.

This is an excellent method of preparation to provide nutrition for infants and invalids ^{4Reference 4A Modern Herbal · 1931Slippery ElmView study →}.

Enemas can also be made from slippery elm bark (2 drachms) by mixing the powder with sugar (1 OZ) and olive oil (1 OZ) and warm milk (1/2 pint) and water (1/2 pint). This combination is suggested for constipation. ^{4Reference 4A Modern Herbal · 1931Slippery ElmView study →}.

Pharmacology & Medical Research

Demulcent/Emollient

Mucilages and mucilaginous plants are hydrophilic, which allows them to trap water. This causes them to swell in size, and develop a consistency similar to gel.

Gels, in general, tend towards having a soothing action on wounds such as burns, ulcers, and irritations. This action also affects the gastrointestinal tract when taken internally. They promote healing of mucosal layers and provide a protective barrier to the damaged tissue. ^{2,10,11Reference 2Braun et al. · 2010Herbs & natural supplements: An evidence-based guide VolReference 10Mills et al. · 2000Principles and practice of phytotherapy: Modern herbal medicineReference 11Morton · 1990Mucilaginous plants and their uses in medicineView study →}.

Phytochemistry

Slippery elm is, in practical terms, a one-compound herb: its demulcent activity rests almost entirely on the mucilage of the inner bark, which makes up roughly 7% of the dried bark ^{1,7Reference 1Barnes et al. · 2007Herbal medicines (3rd ed.)Reference 7Beveridge R.J · 1969Some structural features of the mucilage from the bark of Ulmus fulvus}. This is a highly branched, hydrophilic polysaccharide built mainly from D-galactose, L-rhamnose, and D-galacturonic acid together with the unusual sugar 3-O-methyl-D-galactose ^{7Reference 7Beveridge R.J · 1969Some structural features of the mucilage from the bark of Ulmus fulvus}. Because the chains trap water and swell into a viscous gel — rather than dissolving — the bark coats and soothes mucosal surfaces, which is why it is taken as a gruel and applied as a poultice ^{10,11Reference 10Mills et al. · 2000Principles and practice of phytotherapy: Modern herbal medicineReference 11Morton · 1990Mucilaginous plants and their uses in medicineView study →}.

Beyond the mucilage, the bark carries only minor secondary constituents: astringent tannins, the phytosterol β-sitosterol, and calcium oxalate, none of which is present in pharmacologically dominant amounts ^{8Reference 8Duke · 2016Dr Dukes phytochemical and ethnobotanical databasesView study →}.

Constituent Summary

Figure is share of dried inner bark; the mucilage cannot be extracted by alcohol and only swells in water. Browse a class to see related compounds, or any compound for its full profile.

Clinical Applications

The high mucilage in slippery elm makes it useful for treating inflammatory conditions of the skin, gastrointestinal tract, and respiratory tract. It has mild antibacterial and antifungal actions and has significant vulnerary actions on the mucosal layer of the GIT.

The high vitamin and mineral content make it useful for conditions like anorexia and convalescence.

Topically, slippery elm is useful as a poultice for inflamed and damaged skin, and is useful for treating allergic reactions on the skin.

Synergy

Combine with licorice, marshmallow, and Pleurisy root for pleurisy ^{4Reference 4A Modern Herbal · 1931Slippery ElmView study →}.

Combine with male fern for tapeworms ^{4Reference 4A Modern Herbal · 1931Slippery ElmView study →}.

Essiac tea is a famous combination consisting of Ulmus rubra (slippery elm), Arctium lappa (burdock), Rumex acetosella (sorrel), and Rheum officinale (rhubarb).

This traditional herbal formula was developed by the Ojibwa tribe of Canada and used to treat conditions such as allergies, hypertension, and osteoporosis.

More recently essiac tea has been suggested for cancer. There have been a few studies conducted that indicate the usefulness of essiac tea for protecting the DNA of cells, and reducing the side effects of chemotherapy or radiation therapy in cancer patients. ^{2,12Reference 2Braun et al. · 2010Herbs & natural supplements: An evidence-based guide VolReference 12Leonard et al. · 2006Essiac tea: Scavenging of reactive oxygen species and effects on DNA damageView study →}.

References

1. Barnes, J., Anderson, L. A., & Phillipson, J. D. (2007). Herbal medicines (3rd ed.). London, United Kingdom: Pharmaceutical Press.(Pg. 545-546).
2. Braun, L., & Cohen, M. (2010). Herbs & natural supplements: An evidence-based guide Vol. 2. Sydney: Elsevier Australia. (Pg. 916-919).
3. Ulbricht C.E, Basch E.M, (2005). Natural standard herb and supplement reference. St. Louise: Mosby.
4. A Modern Herbal. (1931). Slippery Elm. Retrieved from http://www.botanical.com/botanical/mgmh/e/elmsli09.html
5. Hoffmann, D. (2003). Medical herbalism: The science and practice of herbal medicine. Rochester, VT: Healing Arts Press. (Pg. 591)
6. US Forest Service. (n.d.). Ulmus rubra. Retrieved August 2, 2016, from http://www.fs.fed.us/database/feis/plants/tree/ulmrub/all.html
7. Beveridge R.J. (1969). Some structural features of the mucilage from the bark of Ulmus fulvus. Carbohydr Res 9 429-439
8. Duke, J. A. (2016). Dr Dukes phytochemical and ethnobotanical databases. Retrieved August 5, 2016, from https://phytochem.nal.usda.gov/phytochem/plants/show/2060?qlookup=ulmus&offset=0&max=20&et=
9. Watts, C., & Rousseau, B. (2012). Slippery Elm, its Biochemistry, and use as a Complementary and Alternative Treatment for Laryngeal Irritation. Journal of Investigational Biochemistry, 17-23. doi:10.5455/jib.20120417052415
10. Mills, S., & Bone, K. (2000). Principles and practice of phytotherapy: Modern herbal medicine. Edinburgh: Churchill Livingstone.
11. Morton, J. (1990). Mucilaginous plants and their uses in medicine. Journal of Ethnopharmacology, 29(3), 245-266. doi:10.1016/0378-8741(90)90036-s
12. Leonard, S. S., Keil, D., Mehlman, T., Proper, S., Shi, X., & Harris, G. K. (2006). Essiac tea: Scavenging of reactive oxygen species and effects on DNA damage. Journal of Ethnopharmacology, 103(2), 288-296. doi:10.1016/j.jep.2005.09.013
13. Bean, W. J. (1970). Trees & Shrubs Hardy in the British Isles, 8th ed., p. 656. (2nd impression 1976) John Murray, London. ISBN 9780719517907