Can Slippery Elm Alleviate Heartburn Symptoms? Exploring The Evidence -

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Research into the use of slippery elm (Ulmus rubra or Ulmus fulva) for treating acid reflux, heartburn, or gastroesophageal reflux disease (GERD) is limited, with most studies offering anecdotal or preliminary evidence rather than robust clinical trials. Below is a summary of findings from authoritative sources (numbers in brackets are references at the end of the article), so you can see for yourself if it could form one of the remedies for heartburn for you. Many people get occasional heartburn, but if your heartburn symptoms persist or you have chronic heartburn, always consult a healthcare professional to ensure they don’t mask something more serious.

What Is Slippery Elm?

Slippery elm is a tree native to North America. The inner bark has been used for centuries in traditional medicine as a herbal remedy due to its soothing properties. It is rich in mucilage, a gel-like substance that can help coat and protect mucous membranes in the digestive tract.

Slippery elm is considered by some people as a natural remedy to treat various conditions, including:

Digestive Conditions: It is often used for conditions like gastroesophageal reflux disease (GERD), heartburn, and inflammatory bowel diseases, as it may help alleviate irritation in the digestive tract.
Sore Throat: The soothing properties of slippery elm can help relieve throat irritation and coughs.

Skin Conditions: It may be applied topically for skin irritations and wounds due to its anti-inflammatory and healing properties.
Respiratory Conditions: It can help soothe coughs and respiratory irritation.

However, there is very little evidence to confirm its efficacy in treating these conditions, and its use should be approached with caution. While it is generally considered safe for most people, it is always advisable to consult with a healthcare professional before using it, especially for those who are pregnant, breastfeeding, or taking other medications.

Slippery elm is available as a herbal supplement in various forms, including powders, capsules, lozenges, and teas.

How Does It Work?

Slippery elm contains mucilage, a substance that forms a gel-like coating when mixed with water. This coating can soothe and protect the esophagus and stomach lining from irritation caused by acid reflux[1][2][3].

It may also stimulate mucus production in the gastrointestinal tract, potentially protecting against ulcers and excess acidity[1][3].

Is It Effective for Treating Acid Reflux (GERD)?

A 2022 review of fibers, herbs, and botanicals for upper gastrointestinal conditions, including GERD, concluded that there is insufficient data and limited evidence to confirm the efficacy of slippery elm for reducing acid reflux symptoms[4][5].

While many users report symptom relief, scientific validation remains lacking. Some studies suggest it may be helpful as part of a broader herbal formula but not as a standalone treatment[4][6][5]. A study on the NC Gut Relief Formula, which includes slippery elm along with other ingredients (e.g., curcumin, aloe vera), showed significant improvement in gastrointestinal symptoms, including heartburn. However, the effects cannot be attributed solely to slippery elm[6].

Most studies on slippery elm involve its use in combination with other herbs or for conditions like irritable bowel syndrome (IBS) rather than GERD specifically[4][6]. Larger clinical trials are needed to establish its efficacy and safety for GERD treatment.

Is Slippery Elm Safe to Take?

Slippery elm is classified as “generally recognised as safe” (GRAS) by the Food and Drug Administration in the US. In the UK the Medicines & Healthcare Products Regulation Agency (MHPRA) has included whole bark and unpowdered slippery elm on its “Banned & Restricted Herbal Ingredients” list but does not list the powdered product.

The unpowdered bark is on the list, as it can only be sold in premises that are registered pharmacies and by or under the supervision of a pharmacist. However, it may interfere with the absorption of medications or nutrients due to its coating properties[7][5].

Possible Side Effects

What are the potential side effects of using slippery elm for acid reflux?

Potential side effects are generally mild, but there are some precautions to consider:

Allergic Reactions: Some individuals may experience allergic reactions, including skin irritation or rash when applied topically[8][9].

Digestive Interference: Slippery elm’s mucilage can coat the digestive tract, which may slow the absorption of medications or nutrients. It is recommended to take slippery elm at least one hour after other medications to avoid interactions[1][10][3]

Pregnancy and Breastfeeding: Slippery elm has a folkloric reputation for potentially inducing miscarriage when ingested or inserted into the cervix during pregnancy. Although there is no scientific evidence confirming this, pregnant and breastfeeding individuals are advised to avoid it[8][9][10].

Children: Its safety for children has not been established, so caution is advised[8].

Supplement Quality: Slippery elm supplements are not regulated by the FDA (US) or the MHPRA (UK), so their contents may vary. Always read Slippery Elm supplement labels and consult a healthcare provider before use[1][10].

General Safety

Most people tolerate slippery elm well, with little to no serious side effects reported in research[3][11]. However, it is essential to consult a healthcare provider before starting Slippery Elm, especially if you are on other medications or have underlying health conditions.

How quickly can slippery elm relieve acid reflux symptoms?

Slippery elm may provide relief from acid reflux symptoms relatively quickly, often within minutes to hours after consumption, depending on the severity of symptoms and individual response. Its mucilage content forms a soothing gel that coats the esophagus and stomach lining, potentially alleviating irritation caused by acid reflux[1][10][12].

However, the onset of relief can vary, according to anecdotal evidence. Some individuals report feeling relief shortly after consuming slippery elm in the form of tea, lozenges, or powder mixed with water[12][8].

Consistency Matters: For sustained benefits, regular use (e.g., 1–3 times daily) may be necessary to maintain the protective coating and manage symptoms over time[1][3].

While anecdotal evidence supports its quick soothing properties, more clinical research is needed to confirm its efficacy and determine how rapidly it works for acid reflux[4][10].

What are the best ways to consume slippery elm for acid reflux?

Here are the best ways to consume slippery elm for acid reflux, and dosage recommendations, based on expert recommendations:

Slippery Elm Bark Powder Preparation: Mix 1–2 tablespoons of slippery elm powder with a glass of water or tea. Stir well until it forms a gel-like consistency. When to Take: Consume after meals and before bedtime, up to three times daily. Tips: Avoid using too much powder, as it can thicken excessively and become difficult to swallow. You can add honey or a sweetener to improve the taste[4][13][5].
Tea Preparation: Brew slippery elm tea by steeping the powdered bark in hot water. Recipes for making tea are widely available online. When to Take: Drink after meals or when symptoms arise. Benefits: The warm liquid can enhance the soothing effect on the esophagus[4][13].
Lozenges Usage: Lozenges are pre-made and easy to use for quick relief. Let them dissolve slowly in your mouth. Benefits: They coat the throat and esophagus, providing a soothing effect[1][2].

Capsule Form or Tablets Usage: Take these as directed on the product label, typically 1–2 capsules up to three times daily. Benefits: Convenient for those who prefer not to prepare powders or teas[1][2].

General Tips: Always follow product-specific instructions and dosage recommendations and consult a healthcare provider before starting slippery elm, especially if you are on medications, as it may interfere with absorption.

Avoid excessive use, as slippery elm’s high fibre content may cause mild digestive discomfort in some individuals.

Lack of Long-Term Research

There is no extensive research, nor clinical trials on the long-term safety and health benefits of taking slippery elm. Its prolonged use should be monitored under medical supervision[10][14].

Conclusion

While slippery elm is generally recognized as safe (GRAS) by the FDA, and shows promise as a soothing agent for heartburn and GERD symptoms due to its mucilage content, scientific evidence supporting its efficacy for acid reflux is limited, with a lack of robust evidence, and largely based on anecdotal evidence. More research is needed to confirm its place as a remedy for heartburn and establish optimal dosages and long-term safety. Consult a healthcare provider before incorporating it into your healthcare regimen, especially if you are pregnant, breastfeeding, or taking other medications.