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Known interactions

No interactions found.

Application of Elm

Scientific Name: Slippery elm

Other Names: American Elm, Elm, Indian Elm, Japanese Elm, Moose Elm, Red Elm, Sweet Elm, Ulmus fulva, Ulmus rubra, Winged Elm

Who is this for?

All species of elm contain varying amounts of mucilage, which may help to relieve coughs and other symptoms that are associated with respiratory conditions such as bronchitis. Mucilage may also make elm useful for treating gastrointestinal conditions. Mucilage is a substance that swells up and becomes slippery, but does not dissolve when mixed with fluids. It coats the mouth, esophagus, and gastrointestinal tract with a slick residue. Therefore, it may soothe a sore throat, help to alleviate the pain of colic or stomach ulcers, and relieve inflammatory bowel conditions. Additionally, elm may promote the production of gastrointestinal mucus, further protecting the linings of the stomach and intestines. Results from a recent laboratory study suggest that elm contains antioxidants that may reduce intestinal inflammation. Antioxidants are thought to protect body cells from damage caused by a chemical process called oxidation. Oxidation produces oxygen free radicals, natural chemicals that may suppress immune function. No human studies have been conducted to confirm any of these traditional uses of elm.

Elm may be used to treat constipation. In the gastrointestinal tract, the mucilage in elm absorbs water. However, because the body cannot digest mucilage, the soft mass that it forms moves through the intestines. Additionally, it may prompt muscles in the intestines to contract. Both effects may help to relieve constipation, but they have not been proved in human studies.

Topically, elm may be applied to the skin surface to relieve minor injuries such as burns, cold sores, razor burn, scrapes, and sunburn. Typically applied as a poultice — a soft cloth soaked in a medication and applied to an injured area of skin — elm has also been made into salves by mixing it with an oily ointment base.

When should I be careful taking it?

The outer bark of elm is known to contain chemicals that may cause pregnant women to miscarry. Although the inner bark, which is used in medicine, is not believed to contain these chemicals, pregnant women are still advised not to take elm.

What side effects should I watch for?

Applying elm to the skin may cause burning, itching, rash, redness, or scaling at the site of application.

Touching elm products or breathing elm tree pollen may cause allergic reactions in individuals who are sensitive to them.

What interactions should I watch for?

No interactions have been identified between elm and drugs, other herbal products, or foods. However, because the mucilage that elm contains may coat the stomach and intestines, it may block or delay the absorption of drugs or nutrients. If elm is taken by mouth, the longest amount of time possible ¯ at least 2 hours ¯ should be allowed between taking elm and eating or taking medications.

Some interactions between herbal products and medications can be more severe than others. The best way for you to avoid harmful interactions is to tell your doctor and/or pharmacist what medications you are currently taking, including any over-the-counter products, vitamins, and herbals.

Should I take it?

Several species of elm trees are thought to have originated in the eastern part of North America - particularly in the Appalachian Mountain region. Although the elm leaves were collected, dried, and used occasionally as a tea or skin wash; the "inner" bark (the light-colored, spongy layer between the rough "outer" bark and the wood of the tree) was most used by Native People and colonists. Some Native People used the inner bark for food - it is easily digested and it is high in carbohydrates. They used it to waterproof their baskets, canoes, and dwelling places as well. Early colonists made a pudding of elm with milk and eggs; they used it to thicken jelly; they added it to grease to prevent rancidity; and they carried it on trips as a light weight "survival" food. For medicine, elm was multi-purpose. It was applied to treat arthritis, gout, toothache, and all kinds of skin injuries. Orally, it was used to eliminate intestinal worms as well as to relieve coughs and stomach aches.

Elm's inner bark continues to be used today, even though the numbers of elm trees in the United States were drastically reduced by Dutch Elm disease during the 1970s. In the spring, sections of the bark are removed carefully from the trunk or large limbs of mature trees. If large amounts are taken the tree will die, and young trees must be at least 10 years old to have enough inner bark to harvest. After the light brown inner bark is separated from the rough, darker outer bark, the inner bark is dried and then shredded or powdered. Large scale processing of inner elm bark is dangerous because the powder is very flammable. Like grain dust in silos, it may explode and burn under certain conditions. Currently, elm is included in an herbal remedy known as Essiac. This preparation, which also contains burdock root, sheep sorrel, and turkey rhubarb root, is sold to treat cancer, but no scientific evidence from laboratory, animal, or human studies support this use.

Dosage and Administration

Usually sold under the name "slippery elm", the most common products made from elm are throat lozenges. It is also sold in oral forms such as liquid tinctures and capsules. The capsules should be taken with a full glass of water because they swell when wet. They may cause a blockage of the esophagus if they become stuck in the throat. Elm products have varying recommendations for use, so the directions on the package that is purchased should be followed.

Elm may be made into a drink or a thin cereal-type food (usually called "gruel") by mixing about one teaspoon of the powdered bark into about an ounce of cold water. Once the powdered elm bark is dissolved, up to 8 ounces of boiling water or other liquid may be added. Elm gruel has been used as food for babies and individuals who are unable to eat solid foods. Both elm gruel and drinks made from elm have a thick texture and a bland taste, so they are often flavored before consumption.

Summary

Elm is included in cough lozenges and other products to treat coughing. It may also soothe the gastrointestinal tract and help relieve constipation, when it is taken by mouth. It may help to heal skin conditions, when it is applied topically.

Risks

Using inner bark of elm is not known to cause problems during pregnancy. However, if any of the outer elm bark is ingested by a pregnant woman, a miscarriage is a remote possibility.

Side Effects

No side effects have been attributed to taking elm by mouth. It may cause rashes or other skin irritation if it is applied or handled.

Interactions

Although elm is not known to interfere with any drugs, other herbals or foods; taking it by mouth may slow down or stop absorption of other substances from the intestines.

References

Anon. Essiac for cancer? Treatment Update. 1998;10(5):4-5.

Anon: Slippery elm. In: DerMarderosian A, Beutler JA, eds. Facts and Comparisons: The Review of Natural Products. St. Louis, MO, Facts and Comparisons. February 1999.

Czarnecki D, Nixon R, Bekhor P, Mason G. Delayed prolonged contact urticaria from the elm tree. Contact Dermatitis. 1993;28(3):196-197.

Das S, Shillington L, Hammett T. Non-timber forest products. Fact sheet no. 17. Slippery elm. Special Forest Products Program, Virginia Technical University. January 2001. Available at: http://www.sfp.forprod.vt.edu/factsheets/elm.pdf. Accessed November 26, 2003.

Day S. Slippery elm - Ulmus fulva. Alternative HealthZine. 2000;10:2. Available at: http://www.alternative-healthzine.com/html/1100_2.html. Accessed November 26, 2003.

Felter HW, Lloyd JU. King's American Dispensatory. Eighteenth Edition. Third Revision. Cincinnati, Ohio. Ohio Valley Co. 1898. Available at: http://www.ibiblio.org/herbmed/eclectic/kings/intro.html. Accessed: November 21, 2003

Grieve M. Elm, slippery. In: A Modern Herbal. New York: Dover Publishers, 1971. Available at: http://www.botanical.com/botanical/mgmh/mgmh.html Posted 1995. Accessed November 21, 2003.

Hoffmann DL. Slippery elm. Herbal Materia Medica. No date given. Available at: http://www.healthy.net/asp/templates/article.asp?PageType=article&ID=1460. Accessed November 26, 2003.

Jellin JM, Gregory P, Batz F, Hitchens K, et al, eds. Pharmacist's Letter/Prescriber's Letter. Natural Medicines Comprehensive Database, 3rd Edition. Stockton CA: Therapeutic Research Facility, 2000.

Kemper KJ. Slippery elm. The Longwood Herbal Task Force. Revised September 15, 1999. Available at: http://www.mcp.edu/herbal/slipperyelm/slipperyelm.pdf Accessed: November 26, 2003.

Kim KS, Lee SD, Kim KH, Kil SY, Chung KH, Kim CH. Suppressive effects of a water extract of Ulmus davidiana Planch (Ulmaceae) on collagen-induced arthritis in mice. Journal of Ethnopharmacology. 2005;97(1):65-71.

Langmead L, Dawson C, Hawkins C, Banna N, Loo S, Rampton DS. Antioxidant effects of herbal therapies used by patients with inflammatory bowel disease: an in vitro study. Alimentary Pharmacology and Therapeutics. 2002;16(2):197-205.

Lee SJ, Oh PS, Ko JH, Lim K, Lim KT. Protective effect of glycoprotein isolated from Ulmus davidiana Nakai on carbon tetrachloride-induced mouse liver injury. Journal of Pharmacy and Pharmacology. 2006;58(1):143-152.

Leonard SS, Keil D, Mehlman T, Proper S, Shi X, Harris GK. Essiac tea: scavenging of reactive oxygen species and effects on DNA damage. Journal of Ethnopharmacology. 2006;103(2):288-296.

Majchrowicz MA. Essiac. Notes from the Underground. 1995;29(Winter):6-7.

MedLine Plus. Essiac. September 1, 2005. Available at: http://www.nlm.nih.gov/medlineplus/druginfo/natural/patient-essiac.html. Accessed June 8, 2006.

Tai J, Cheung S. In vitro culture studies of FlorEssence on human tumor cell lines. Phytotherapy Research. 2005;19(2):107-112.

Weber RW. American elm (Ulmus americana) is a native tree that has had a wide range from the entire eastern states through the central plains. Annals of Allergy, Asthma and Immunology. 2001;86(2):A7.


(Note: The above information is not intended to replace the advice of your physician, pharmacist, or other healthcare professional. It is not meant to indicate that the use of the product is safe, appropriate, or effective for you.)

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