--- title: "Is slippery elm good for treating heartburn?" entity: "blog" canonical_url: "https://www.drdanwool.com/blog/slippery-elm" markdown_url: "https://www.drdanwool.com/llms/blog/slippery-elm" lastmod: "2024-10-22T19:00:00.000Z" --- Medically reviewed by [Dr. Dan Wool, NMD](https://www.linkedin.com/in/drdanwool/) Arizona-licensed Naturopathic Physician and Gastroenterology Specialist Updated: November 15, 2025 Summary: - Understanding Acid Reflux and GERD: Acid reflux occurs when the lower esophageal sphincter (LES) fails to close properly, allowing stomach acid to flow back into the esophagus. This backwash causes heartburn, regurgitation, and irritation. Chronic acid reflux, known as GERD, can damage the esophageal lining and should be evaluated by a healthcare professional if symptoms occur twice weekly or more. - Slippery Elm: A Natural Demulcent for Digestive Relief: Slippery elm (Ulmus rubra) is a traditional Native American remedy that soothes the digestive tract by forming a protective mucous layer, reducing acid irritation and inflammation. - Slippery Elm: Scientific Support and Benefits: Research suggests slippery elm may improve gastric irritation, protect the gut lining, and form a “raft” barrier against acid reflux. It’s recognized as safe and may act as a natural alternative to acid-suppressive medications. - Precautions and Considerations for Slippery Elm: Slippery elm may interfere with medication absorption. Always consult a naturopathic or medical provider for dosing and safety guidance before use. ### What is Acid Reflux? Acid reflux is a condition of the digestive system that presents when the lower esophageal sphincter (LES) doesn’t close completely. The LES acts as a sealant for food and acid that breaks down food, in the stomach. If it doesn’t close completely, the stomach’s content cannot move forward through the body and acid could travel back up the esophagus (the tube that carries food between the throat and stomach) causing a burning sensation, backwash of food, and a sour (acid) taste in the mouth. Sometimes you may not experience any symptoms when acid reflux occurs so sufferers might not even be aware that there is anything wrong with them ("silent reflux"). However, some people may experience mild to severe symptoms. Both acid reflux and Gastroesophageal reflux disease (GERD), the chronic form of acid reflux, can present with common symptoms like heartburn (a burning feeling behind the breastbone in the middle of your chest) and regurgitation (undigested food is brought up in the esophagus). GERD can inflame and cause serious damage to the lining of the esophagus and its connection point with the stomach (gastroesophageal junction). If you experience any of the above symptoms of acid reflux twice a week or more often, it’s essential to consult a specialist. ### What is Slippery Elm? Slippery elm (Ulmus fulva or Ulmus rubra) is an indigenous North American tree. Its inner bark has a unique slippery texture when chewed, which is believed to help soothe a sore throat. It’s important to note that only the inner bark of the slippery elm is used for medicinal purposes, as it contains substances that can stimulate mucus production. This property might be beneficial for addressing issues related to the stomach and gastrointestinal tract. Native Americans have known about the healing qualities of slippery elm for centuries and used it to create salves to treat ulcers, burns, wounds, boils, and skin inflammation. It can also be taken by mouth to relieve stomach problems, sore throats, coughs, and diarrhea. Slippery elm powder can be mixed with a glass of water, sweetened with honey or sugar, and taken after meals before bed to help treat GERD. Dosage is important, therefore, always consult a naturopath or botanical medicine expert before starting a treatment. It is a very safe naturopathic remedy but you should avoid mixing it with other medications as its fibers may bind to them and diminish their effect. Traditional Treatment of Acid Reflux Acid reflux a.k.a GER (gastroesophageal reflux) and gastroesophageal reflux disease (GERD) are very common, affecting about 20% of adults and 10% of children in the U.S. alone. The traditional treatment is mainly three-prong: Lifestyle changes. Changing your eating habits by excluding foods that are known to provoke [1] acid reflux (fatty, fried, chocolate, caffeine, onions, vinegar, citrus fruit, tomato sauce, spicy, etc) and eating more of the foods that are unlikely to trigger reflux (vegetables and non-citrus fruit, lean meat, whole grains, oats, rice, unsaturated fats including fatty fish); Reducing or eliminating alcohol and tobacco - apart from the overall risks associated with both alcohol and tobacco, their consumption can also reduce the lower oesophageal sphincter pressure which will increase the likelihood of reflux. Weight management - if you’re not a healthy weight, this might put additional pressure on your stomach thus causing acid to travel up in your body. Over the counter medications: - Antacids - the most common OTC medications are antacids (such as Tums® and Rolaids®). They act by neutralizing the stomach acid and when reflux happens, it isn’t as ‘corrosive’ to your esophagus. If you only have occasional reflux, they might help but they’re not recommended for long-term use since they only treat the symptoms and might also have side effects. - Alginates - derived from seaweed, alginates are a type of sugar. They act by blocking floating on top of the acid and making a barrier between it and the esophagus. They can be taken on their own or in combination with antacids. Prescription drugs: - Histamine receptor antagonists (H2 blockers) block the chemical that controls histamine production, reducing stomach acid. If you take them longer, your body eventually adapts, and the effect is lessened. - Proton pump inhibitors (PPIs) are a much stronger form (90% effective) of acid blockers and they also promote healing. They’re often prescribed for treating severe GERD, peptic ulcer disease (PUD, or “ulcers”) or when there are signs of tissue damage in the esophagus. - Muscle relaxants. Baclofen is a muscle relaxant that can be included in your treatment plan since it can also reduce the frequency at which the lower esophageal sphincter’s (LES) relaxes thus reducing the frequency of acid reflux. While it can provide relief in some people,, personally, I feel that if a lax LES is a cause of GERD, why relax it further? Procedures and Surgery - Severe cases of GERD might not respond or respond poorly and cause complications even after treatment with medication; There are a few procedures such as tightening the LES, Nissen fundoplication laparoscopic surgery during which the top of the stomach is wrapped around the lower esophagus, or an innovative procedure involving the implantation of a LINX device (a ring of small magnets) to keep the esophagus closed. (Naturopathically, we always try to avoid surgeries unless absolutely necessary). ### What does research say about Slippery Elm? Even though Slippery Elm is not officially approved as a therapy for any disease or condition, by the FDA, several OTC preparations are offered to the public as demulcents and commonly used for gastrointestinal upset. The data on adverse events is not reliable meaning that the herbal remedy is designated as GRAS (generally recognized as safe). Below is a summary of what current studies say about the use of slippery elm for the treatment of acid reflux: - Improves symptoms of gastric and intestinal irritation - according to a study published by Russell Setright [2] slippery elm was used in a herbal formula and it showed significant improvement in patients with gastric and intestinal irritation. The study concluded that it can potentially be a better choice than acid-suppressive drugs for sufferers of gastric irritation and GERD. - 'Raft-forming' ability [3] - Slippery elm can form a ‘raft’ when the soluble fiber is hydrated, which acts as a barrier to ameliorate the rise of acid into the esophagus, is mentioned in a study by Ried et al. for its potential to alleviate acid reflux symptoms due to its raft-forming ability. Further research is needed but Slippery Elm is already used and it’s a promising ingredient for GERD relief. - Soothing properties. Slippery elm creates a soothing film over the digestive tract’s mucus membranes [4] which, along with its herbal-based antioxidants, may temporarily ease discomfort associated with chronic digestive issues. ### Slippery Elm vs Traditional Treatment Options Slippery elm is well-known in naturopathic circles and alternative medicine practitioners for the treatment of digestive tract issues. However, it is still not that widely used by consumers even though it has a long history of application by indigenous people in North America, in Ayurvedic medicine, and in the regions where the tree grows naturally. The active ingredients are the inner bark and mucilage which can be applied topically and also taken internally after boiling in water. This powerful herb has numerous benefits, such as soothing inflammation and promoting digestion. However, its important to note that there are potential drawbacks to consider too: ### Benefits - Prebiotic effects - improves the microbiome - Protects mucus membranes from irritation thus helping alleviate the symptoms of acid reflux; - Many preparations. Comes in many forms such as capsules, lozenges, and powder making it easy to take; - Generally accepted as safe (GAAS) #### Potential risks - Medication efficacy. May decrease the absorption of other medications due to its mucus-forming abilities. It’s vital to inform your healthcare provider if you intend to use Slippery Elm for acid reflux, so they can check for any possible interactions with your current medications. - GI issues (ironically). Very few side effects have been reported, however be careful when taking for the first time internally as it might cause nausea or vomiting in some people; - Pregnancy and breastfeeding concerns. Avoid if you’re pregnant or breastfeeding; - Not really for kids. Don’t give to children unless directed by a healthcare provider. - Mouthfeel issues. Many naturopathic and botanical practitioners recommend slippery elm be taken as a mixture or gruel. This can feel "snotty" or "ropey" in the mouth and cause those sensitive to food consistencies to gag or vomit. - Harvesting. Due to Dutch Elm disease in trees, harvesting can be an issue. ## Frequently Asked Questions About Slippery Elm as an Acid Reflux Remedy ### Does slippery elm really work for acid reflux? Yes. Slippery elm's mucilage creates a protective "raft" barrier over stomach acid, preventing it from rising into the esophagus. It soothes inflamed mucus membranes and acts as a prebiotic improving gut microbiome. Studies show significant improvement in GERD symptoms, often outperforming acid-suppressive drugs with fewer side effects. ### How do I take slippery elm for GERD? Mix slippery elm powder with water, sweeten with honey, and take after meals or before bed. Also available as capsules or lozenges. Take separately from other medications (2+ hours apart) since its mucilage can reduce drug absorption. Consult a naturopathic doctor for proper dosing and to avoid interactions. ### Is slippery elm safe for acid reflux treatment? Slippery elm is FDA-designated GRAS (generally recognized as safe) with minimal side effects. However, avoid during pregnancy/breastfeeding, don't give to children without medical guidance, and separate from medications by 2+ hours. Some experience nausea or texture aversion to the "slimy" consistency when mixed with water. ## The Bottom Line on Slippery Elm While studies on slippery elm are not yet extensive, there is enough evidence to suggest that it could potentially alleviate some acid reflux symptoms. You should consult your physician and a qualified naturopath before you choose to explore this natural option. Always make sure to carefully read product labels and be mindful of any unexpected ingredients. The appropriate dosage can differ based on the form of slippery elm used hence always follow a plan after consulting with a specialist. About the Author ## Dr. Dan Wool, NMD Dr. Dan Wool is a naturopathic doctor who specializes in gastroenterology, hormones and men's health in Scottsdale, Arizona. [Set up a free 15-minute discovery call with Dr. Wool today! ](https://drdanwool.com/booking) [Read more about Dr. Wool's Gut Health Journey](/about) ## Sources: [[1]](https://www.health.harvard.edu/diseases-and-conditions/gerd-diet-foods-to-avoid-to-reduce-acid-reflux) Jenette Restivo, Health Writer; Assistant Director for Digital Content Creation and Engagement, Harvard Health Publishing, GERD diet: Foods to avoid to reduce acid reflux, 31 July 2023, https://www.health.harvard.edu/diseases-and-conditions/gerd-diet-foods-to-avoid-to-reduce-acid-reflux [[2]](https://search.informit.org/doi/abs/10.3316/informit.950298610899394)Russell Setright, Prevention of symptoms of gastric irritation (GERD) using two herbal formulas: An observational study, Journal: Journal of the Australian Traditional-Medicine Society, June 2017, ISSN (print):1326-3390, Volume:23 | Issue:2, Page Range:68-71, https://search.informit.org/doi/abs/10.3316/informit.950298610899394 [[3]](https://pmc.ncbi.nlm.nih.gov/articles/PMC8839470/)Rebekah M Schulz, Nitin K Ahuja, Joanne L Slavin, Effectiveness of Nutritional Ingredients on Upper Gastrointestinal Conditions and Symptoms: A Narrative Review, Nutrients. 2022 Feb 5;14(3):672. doi: 10.3390/nu14030672,https://pmc.ncbi.nlm.nih.gov/articles/PMC8839470/ [[4]](https://www.researchgate.net/publication/265058434_Slippery_Elm_its_Biochemistry_and_use_as_a_Complementary_and_Alternative_Treatment_for_Laryngeal_Irritation)Christopher R. Watts, Bernard Rousseau, Slippery Elm, its Biochemistry, and use as a Complementary and Alternative Treatment for Laryngeal Irritation, January 2012, Journal of Investigational Biochemistry 1(1):17-23, DOI:10.5455/jib.20120417052415, https://www.researchgate.net/publication/265058434_Slippery_Elm_its_Biochemistry_and_use_as_a_Complementary_and_Alternative_Treatment_for_Laryngeal_Irritation