Demulcents and Mucilages: True Digestive Healers
Written By: Millie Lytle, ND, MPH, CNS
It’s an old wives’ tale to rely on milk to relieve an upset stomach. Many people believe that milk coats and soothes the digestive lining, eliminating nausea and relieving a sore stomach. Because it has fat and generates mucous, milk may temporarily coat an acidic or sore tummy – but any soothing properties of milk are temporary. The cons of using milk for this purpose is that pasteurized dairy isn’t a true healer. In fact, pasteurized milk and milk products have very few healing abilities, if any at all. Milk is difficult to digest, generating inflammation, excess mucous production and triggering lactose intolerance, all of which could make a sore stomach worse in a significant percentage of the population. On average, 80% of Asian and Native Americans, 75% of African Americans, 51% of Hispanic Americans and 21% of Caucasian Americans are lactose intolerant. 1
A demulcent, on the other hand, is derived from the Latin word for “caress”. A demulcent is an agent that forms a soothing film over a mucous membrane, relieving minor pain and inflammation of the membrane. Demulcents are a classification of plants, sometimes referred to as mucoprotective agents or mucilage-producing agents. Some of the members of this group are food sources, while others come in the form of herbal preparations, tea, dry powder, capsules or tinctures. Demulcent herbs have the ability to act as a protective barrier on irritated or inflamed tissue.2
Demulcents have these general properties
- They reduce irritation down the whole length of the bowel.
- They reduce the sensitivity of the digestive system to gastric acids.
- They help to ease the digestive muscle spasms which cause colic.
Some demulcents also have the ability to
- Ease coughing by soothing bronchial tension.
- Relax painful spasms in the bladder and urinary system, and sometime even in the uterus.
- Corn Silk
- Couch Grass
- Irish/Iceland Moss
- Slippery Elm
When demulcents are used on the skin, they are called emollients. Demulcency cannot necessarily always be explained through pharmacological mechanism, but rather through contact repair. Demulcent plants contain a very special constituent. It’s a polysaccharide molecular complex called mucilage, which has the propensity to become very slimy and gummy when it comes in contact with water. Mucilage is a thick gooey substance produced by many plants. This slime and “gumminess” have a direct action on the areas they touch, such as the lining of the intestines, which helps soothe and reduce irritation by direct contact. There are some remedies that have a similar action far from the sight of absorption into the body – however, there is some pharmacological action in order for them to target organs such as the urinary tract system, where the direct action of mucilage would not be possible due to metabolism.
Mucilage is a viscous secretion or bodily fluid:
- A polysaccharide substance extracted as a viscous or gelatinous solution from plant roots, seeds, etc., and used in medicines and adhesives.
- An adhesive solution; gum or glue.
Mucilage in plants plays a role in the storage of water and food, Seed germination, and thickening membranes. Cacti (and other succulents) and flax seeds especially are rich sources of mucilage. Mucilage is edible. It is used in medicine for its demulcent properties. Mucilage is used medicinally to help alleviate symptoms of:
- Bladder infection/Cystitis
- Damaged skin cells
- Food Poisoning
- High cholesterol
- Prostate enlargement
- Sore throat / Pharyngitis
- Vaginal dryness
Traditional candies, such as horehound cough drops and marshmallows for cough suppressant purposes, were created because of their demulcent properties. In horehound (Marrubium vulgare) it’s the leaves that are mucilaginous, and in marshmallow (Althea officionalis), it’s theroots. The inner bark of the slippery elm (Ulmus rubra), a North American tree species, has long been used as a demulcent to soothe acidity in the stomach and relieve sore throats. Licorice is one of the most powerful demulcents, used for its soothing action in the throat, stomach and intestines. During the fermentation of Nattokinase soybeans, extracellular enzymes produced by the Bacterium Bacillus natto, react with soybean sugars to produce mucilage. The amount and viscosity of the mucilage are important characteristics of natto, contributing to natto’s unique taste and smell. Mucilage is also used in food. The mucilage of two kinds of insectivorous plants, sundew (Drosera), and butterwork (Pinguicula) is used for in a Swedish dairy product called filmjölk, similar to yogurt, but with a different bacteria culture. 3
The following plants are known to contain far greater concentrations of mucilage than is typically found in most plants:
Demulcent treatment alone and in combination with other medications is evidence-based.
- Aloe vera
- Basella alba (Malabar spinach)
- Chondrus crispus (Irish moss)
- Dioscorea opposita (nagaimo, Chinese yam)
- Drosera (sundews)
- Flax seeds
- Kelp and other seaweeds
- Licorice root
- Oats (Aveena sativa)
- Parthenium (feverfew)
- Pinguicula (butterwort)
- Psyllium seed husks
- Salvia hispanica (chia) seed
- Ulmus rubra bark (slippery elm)
- Plantain (Plantago major)
One study found that an herbal preparation of licorice, slippery elm and marshmallow was significantly superior to a placebo and provided a rapid, temporary relief of sore throat pain in patients with pharyngitis.4 Another open trial gave 10 ml per day for 10 days of a thyme and aniseed blend as well as mucilage of marshmallow root. Patients and physicians in the study reported the efficacy of this liquid preparation as “good” or “very good” for alleviating cough, reporting reduction in the symptom score as well as easy tolerance of this herbal cough syrup to alleviate cough that results from the common cold, bronchitis or respiratory tract diseases with formation of mucus. 5
Peptic Ulcer Disease and Oral Mucositis
In a double-blind clinical trial study, 60 people were enrolled to compare licorice root with bismuth for the eradication of H. Pylori in patients with peptic ulcer disease (PUD). The first randomly-assigned group was given licorice, amoxicillin, metronidazole and omeprazole. The second (control) group, bismuth subsalicylate, amoxicillin, metronidazole and omeprazole were prescribed respectively, at week 1 and 4 in order to evaluate H. pylori eradication. Urea breath test was done in all patients. The outcome of the study was the preference for using licorice as an effective medication for H. pylori eradication. 6
Mucositis is a major complication of irradiation in head and neck tumors, and the addition of chemotherapy to irradiation may enhance this dose-limiting problem. Licorice is a strong demulcent that has been effectively used in treatment of peptic ulcers6. The main purpose of this study was to compare the therapeutic safety and efficacy of triamcinolone acetonide and licorice mucoadhesive films on oral mucositis in terms of pain control and/or ulcer treatment. Researchers concluded that both triamcinolone and licorice mucoadhesive films are effective in pain management of oral mucositis during radiotherapy, with an overall trend in the licorice group with the least oral pain. 7
- From https://www.uhs.uga.edu/nutrition/lactoseintolerance.html
- From http://www.healthy.net/scr/article.aspx?Id=1478
- From https://cornersofthemouth.wordpress.com/2011/03/01/the-magic-of-mucilage-by-karin-uphoff/
- Brinckmann J, Sigwart H, van Houten Taylor L. Safety and efficacy of a traditional herbal medicine (Throat Coat) in symptomatic temporary relief of pain in patients with acute pharyngitis: a multicenter, prospective, randomized, double-blinded, placebo-controlled study. J Altern Complement Med. 2003 Apr;9(2):285-98.
- Büechi S, Vögelin R, von Eiff MM, Ramos M, Melzer J. Open trial to assess aspects of safety and efficacy of a combined herbal cough syrup with ivy and thyme. Forsch Komplementarmed Klass Naturheilkd. 2005 Dec;12(6):328-32.
- Momeni A, Rahimian G, Kiasi A, Amiri M, Kheiri S. Effect of licorice versus bismuth on eradication of Helicobacter pylori in patients with peptic ulcer disease. Pharmacognosy Res. 2014 Oct;6 (4):341-4.
- Ghalayani P, Emami H, Pakravan F, Nasr Isfahani M. Comparison of triamcinolone acetonide mucoadhesive film with licorice mucoadhesive film on radiotherapy-induced oral mucositis: A randomized double-blinded clinical trial. Asia Pac J Clin Oncol. 2014 Oct 28. Asia Pac J Clin Oncol. 2014 Oct 28.
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