Slippery Elm

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Slippery Elm

Common Names

  • Indian Elm
  • Red elm
  • Gray elm

For Patients & Caregivers

How It Works

Slippery elm may help to relieve minor cough or sore throat, but there is no clinical evidence to show that it is effective against infections, cancer or other serious medical conditions.

Slippery elm is a tree native to North America. Its bark is used to treat gastrointestinal disorders, sore throat, cough, and skin ulcers. A formula containing slippery elm improved bowel habits and symptoms in patients with constipation-predominant irritable bowel syndrome.

Slippery elm is one of the components in Essiac, an herbal formula used as an alternative cancer treatment.

Purported Uses
  • To treat coughs and bronchitis The mucilage content in slippery elm is thought to relieve coughs and throat irritation, but human data are lacking.
  • To treat cancer Evidence is lacking to support this claim.
  • To treat diarrhea Evidence is lacking to support this claim.
  • To treat irritable bowel syndrome (IBS): A small clinical study found that a formulation containing slippery elm improved bowel habits and symptoms in patients with constipation-predominant IBS.
  • Topically, to treat skin abscesses and ulcers The mucilage content in slippery elm is thought to have a soothing effect when applied topically, but human data are lacking.
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For Healthcare Professionals

Scientific Name
Ulmus rubra
Clinical Summary

Slippery elm is a tree native to North America. Its bark is used to treat gastrointestinal disorders, sore throat, cough, and skin ulcers. Slippery elm is thought to have antioxidant and anti-inflammatory properties. The primary constituent mucilage has demulcent effects. A small clinical study showed that a formulation containing slippery elm improved the bowel habits and symptoms of constipation-predominant irritable bowel syndrome (IBS) (1).

Slippery elm is one of the components in Essiac, an herbal formula used as an alternative cancer treatment.

Purported Uses
  • Bronchitis
  • Cancer treatment
  • Cough
  • Diarrhea
  • Fever
  • Inflammation
  • Peptic ulcers
  • Skin abscesses
  • Skin ulcers
  • Sore throat
Mechanism of Action

Mucilage in slippery elm is responsible for its demulcent, emollient, and antitussive properties. Insoluble polysaccharides in mucilage (hexose, pentose, methylpentose) form a viscous material following oral administration or when prepared for topical use. The fiber content is thought to reduce gastrointestinal transit time, act as a bulk forming laxative, and adsorb toxins. Mucosal biopsies from patients with active ulcerative colitis incubated with slippery elm showed a dose-dependent reduction in oxygen free radicals (4). Another in vitro study also showed antioxidant scavenging activity (5). The tannin component can act as an astringent (2). Fatty acid esters such as oleic and palmitic acid are thought to be responsible for antitumor activity (3), but the specific mechanisms remain unclear.

Dosage (OneMSK Only)
References
  1. Hawrelak JA, Myers SP. Effects of two natural medicine formulations on irritable bowel syndrome symptoms: a pilot study. J Altern Complement Med. 2010 Oct;16(10):1065-71.
  2. Newall C, et al. Herbal Medicines: A Guide for Health-Care Professionals, 1st ed. London: Pharmaceutical Press; 1996.
  3. Tamayo C, et al. The chemistry and biological activity of herbs used in Flor-essence herbal tonic and Essiac. Phytotherapy Res 2000;14:1-14.
  4. Langmead L, Dawson C., Hawkins C, et al. Antioxidant effects of herbal therapies used by patients with inflammatory bowel disease: an in vitro study. Aliment Pharmacol Ther. 2002 Feb;16(2):197-205.
  5. Choi HR, Choi JS, Han YN, et al. Peroxynitrite scavenging activity of herb extracts. Phytother Res. 2002 Jun;16(4):364-7.
  6. Brinker F. Herb Contraindications and Drug Interactions, 3rd ed. Sandy (OR): Eclectic Medical Publications; 2001.
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Email your questions and comments to aboutherbs@mskcc.org.

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