Slippery elm

Slippery elm/Drug Interactions:

  • GeneralGeneral: Slippery elm could theoretically slow down or decrease absorption of other oral medications due to hydrocolloidal fibers, although reports of actual interactions are lacking. Slippery elm contains tannins, which could theoretically decrease absorption of nitrogen-containing substances such as alkaloids, although interactions are lacking in the available literature.
  • AntineoplasticsAntineoplastics: In in vitro and animal research, fatty acids and fatty acid esters similar to those present in slippery elm have been reported to show cytostatic and proapoptotic activity in tumor models, as well as immunomodulation (2; 8). However, improvements in overall health-related quality of life or mood were lacking in human breast cancer patients coadministered slippery elm inner bark (Ulmus fulva or U. rubra), burdock root (Arctium lappa), Indian rhubarb (Rheum palmatum), and sheep sorrel (Rumex acetosella) (Essiac?), in spite of numerous patient-reported beneficial effects (9).
  • DemulcentsDemulcents: Traditionally, slippery elm has been used to treat sore throats, most typically as a lozenge. Theoretically, its constituent mucilage may act as a soothing agent to inflamed mucous membranes. In commercially available lozenges, the presence of slippery elm may result in sustained release of mucilage to the throat, forming a soothing layer over mucous membranes (10).
  • Gastrointestinal agentsGastrointestinal agents: In human research, the coadministration of dried, powdered slippery elm bark, lactulose, oat bran, and licorice root beneficially reduced symptoms of irritable bowel syndrome (IBS), improved the consistency of stools, and increased the frequency of bowel movements in individuals with constipation-predominant IBS, whereas the coadministration of dried, powdered slippery elm bark, bilberry fruit, cinnamon quilts, and agrimony aerial parts beneficially decreased IBS symptoms and adversely increased the frequency of bowel movements in individuals with diarrhea-predominant IBS (6).
  • LaxativesLaxatives: The inner bark of slippery elm is rich in mucilage, consisting of insoluble polysaccharides (hexose, pentose, methylpentose), which, when broken down, are thought to reduce gastrointestinal transit time and act as a bulk-forming laxative. Also, theoretically, its constituent tannins may decrease the water content of stool. In human research, the coadministration of dried, powdered slippery elm bark, lactulose, oat bran, and licorice root beneficially reduced symptoms of irritable bowel syndrome (IBS), improved the consistency of stools, and increased the frequency of bowel movements in individuals with constipation-predominant IBS, whereas the coadministration of dried, powdered slippery elm bark, bilberry fruit, cinnamon quilts, and agrimony aerial parts beneficially decreased IBS symptoms and adversely increased the frequency of bowel movements in individuals with diarrhea-predominant IBS (6).

    • Slippery elm/Herb/Supplement Interactions:

  • GeneralGeneral: Slippery elm may theoretically slow down or decrease absorption of other oral medications due to hydrocolloidal fibers, although reports of interactions are lacking.
  • AntineoplasticsAntineoplastics: In in vitro and animal research, fatty acids and fatty acid esters similar to those present in slippery elm have been reported to possess cytostatic and proapoptotic activity in tumor models, as well as immunomodulation (2; 8). However, improvements in overall health-related quality of life or mood were lacking in human breast cancer patients coadministered slippery elm inner bark (Ulmus fulva or U. rubra), burdock root (Arctium lappa), Indian rhubarb (Rheum palmatum), and sheep sorrel (Rumex acetosella) (Essiac?), in spite of numerous patient-reported beneficial effects (9).
  • DemulcentsDemulcents: Traditionally, slippery elm has been used to treat sore throats, most typically as a lozenge. Theoretically, its constituent mucilage may act as a soothing agent to inflamed mucous membranes. In commercially available lozenges, the presence of slippery elm may result in sustained release of mucilage to the throat, forming a soothing layer over mucous membranes (10).
  • Gastrointestinal herbs and supplementsGastrointestinal herbs and supplements: In human research, the coadministration of dried, powdered slippery elm bark, lactulose, oat bran, and licorice root beneficially reduced symptoms of irritable bowel syndrome (IBS), improved the consistency of stools, and increased the frequency of bowel movement in individuals with constipation-predominant IBS, whereas the coadministration of dried, powdered slippery elm bark, bilberry fruit, cinnamon quilts, and agrimony aerial parts beneficially decreased IBS symptoms and adversely increased the frequency of bowel movements in individuals with diarrhea-predominant IBS (6).
  • LaxativesLaxatives: The inner bark of slippery elm is rich in mucilage, consisting of insoluble polysaccharides (hexose, pentose, methylpentose) which, when broken down, are thought to reduce gastrointestinal transit time and act as a bulk-forming laxative. Also, theoretically, its constituent tannins may decrease the water content of stool. In human research, the coadministration of dried, powdered slippery elm bark, lactulose, oat bran, and licorice root beneficially reduced symptoms of IBS, improved the consistency of stools, and increased the frequency of bowel movement in individuals with constipation-predominant IBS, whereas the coadministration of dried, powdered slippery elm bark, bilberry fruit, cinnamon quilts, and agrimony aerial parts beneficially decreased IBS symptoms and adversely increased the frequency of bowel movements in individuals with diarrhea-predominant IBS (6).

    • Slippery elm/Food Interactions:

  • Insufficient available evidence.

    • Slippery elm/Lab Interactions:

  • Insufficient available evidence.