Evidence supporting the use of: Slippery elm bark
For the health condition: Anal Fistula or Fissure

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Synopsis

Source of validity: Traditional
Rating (out of 5): 1

Slippery elm bark (Ulmus rubra) has a long history of use in North American traditional medicine, particularly among Indigenous peoples and later in Western herbal practice. It is most commonly used for its mucilaginous properties, which can soothe irritated mucous membranes of the digestive tract when taken orally. Traditional herbalists sometimes recommend slippery elm bark as part of a holistic approach to manage conditions like anal fissures or fistulas, primarily because its demulcent (soothing, coating) properties are thought to reduce irritation and promote healing of inflamed tissues. The bark is typically used as a tea, gruel, or topical poultice. However, there is minimal direct scientific evidence to support the effectiveness of slippery elm bark specifically for anal fistula or fissure. Most references are anecdotal or extrapolated from its general use for soothing mucosal irritation in the gastrointestinal tract. No randomized controlled trials or robust clinical studies have evaluated its safety or efficacy for these particular anorectal conditions. The traditional use rating is therefore low, reflecting weak supporting evidence rather than complete absence of use. Patients should consult healthcare professionals for appropriate diagnosis and management of anal fistula or fissure, as these conditions may require medical or surgical intervention.

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