Marshmallow Root

Mucilage / polysaccharides form a protective coating.

Marshmallow root is rich in water-soluble polysaccharides (mucilage) that form a viscous, bio-adhesive layer on epithelial surfaces. That physical film can soothe inflamed mucosa, protect it from acid/irritants and reduce mechanical irritation — a logical mechanism for relieving gastritis symptoms. ABIM ScienceDirect

Anti-inflammatory and wound-healing activity.

In vitro and animal studies show Althaea extracts and isolated polysaccharides exert anti-inflammatory and antioxidant effects, and promote epithelial cell physiology and healing — mechanisms relevant to gastric mucosal protection and ulcer prevention. Frontiers Taylor & Francis Online

Recognized traditional / regulatory use for mild GI mucosal irritation.

European and other herbal monographs (EMA/HMPC, ESCOP) list marshmallow root for relief of mild gastrointestinal mucosal inflammation (e.g., mild gastritis, dyspeptic irritation) based largely on traditional use and the above pharmacology. These monographs treat marshmallow root as a demulcent indicated for mild irritation. European Medicines Agency (EMA)

Common dosage forms

• Dried root (cold infusion / decoction / powder) — most traditional preparations use the dried root in an infusion (often cold or gentle infusion to extract mucilage rather than boiling away it).
• Powder / capsules — powdered root standardized by weight.
• Tincture (1:5 in 25% ethanol or similar) — used in some preparations; concentrated extracts are available.
• Syrups / lozenges — less common for gastritis, more for throat/respiratory use. Health Canada Arzneipflanzenlexikon

Authoritative dosing (from the Canadian Natural Health Product monograph — practical, widely used guidance)

• Adults (18+): 6–15 g of dried root per day, with max ~5 g per single dose (dried root). For relief of gastric mucosal irritation the same daily range (6–15 g) is given. Health Canada
• Preparation (cold infusion method recommended to preserve mucilage): add the dried or powdered root to 150 mL (≈5 oz) of cold water, steep 30 minutes, stir frequently, then strain; you may warm it before drinking but don’t boil. Take the prepared infusion as directed up to the daily doses above. Health Canada
• Tincture guidance: traditional tinctures are described as 1:5 (w/v) in 25% ethanol; some sources list a tincture dose range (example: up to 20–40 mg? — but authoritative monographs list grams dried root equivalents rather than single universal tincture mL doses). See the monograph for product-specific tincture dosing. Health Canada European Medicines Agency (EMA)

Practical tips (from monographs & pharmacopeial guidance)

• Use a cold infusion (steeping in cold water) for mucilage extraction: steep ~30 minutes, stir, strain, and optionally warm. Boiling can change extract properties. Health Canada
• Timing with other medicines: because marshmallow mucilage can physically interfere with intestinal absorption, take marshmallow ½–1 hour before or ~2 hours after other oral medications to avoid reduced absorption. This is repeatedly recommended in monographs. Health Canada Arzneipflanzenlexikon

Key laboratory / preclinical studies (mechanistic & gastroprotective relevance)

• Deters A. et al., Journal of Ethnopharmacology (2010) — shows aqueous extracts and polysaccharides from marshmallow root are internalized by epithelial cells and stimulate epithelial cell physiology (helps explain protective/healing activity). ABIM
• Studies on anti-inflammatory / anti-oxidative activity (in vitro macrophage studies / extracts) — demonstrate Althaea root extract reduces inflammatory markers in cell models. Example: Bonaterra et al., Frontiers in Pharmacology (2020) showing anti-inflammatory/anti-oxidative effects on macrophages. Frontiers
• Animal/experimental anti-ulcer and gastroprotective work — multiple preclinical studies / review articles report anti-ulcer and protective effects in ethanol- or stress-induced gastric injury models (supports plausible activity in gastritis). See modern reviews and experimental papers summarized in review articles. Taylor & Francis Online Phytochemistry Journal

Regulatory / review-level evidence

• European Medicines Agency (EMA) / HMPC monograph — provides a formal assessment: marshmallow root is recognized for traditional use for irritation of mucous membranes including mild GI mucosal irritation. The EMA monograph summarizes available pharmacology and safety data (but the monograph relies largely on traditional use and pharmacological plausibility rather than large modern RCTs). European Medicines Agency (EMA)+1

Human clinical trials for gastritis specifically

• There are few (if any) robust RCTs directly testing marshmallow root vs placebo for gastritis in humans. Most human clinical evidence concerns mucosal irritation (throat, cough), topical uses, or small pilot studies for related mucosal conditions. Reviews repeatedly call for controlled clinical trials to confirm traditional claims for GI uses. See the ESCOP/EMA reviews and recent phytochemical reviews. European Medicines Agency (EMA) Phytochemistry Journal

Summary on evidence: plausible mechanism + supportive preclinical and traditional/regulatory recognition for mild gastric mucosal irritation, but limited direct human RCT evidence specific to gastritis — so treat marshmallow as a supportive demulcent remedy rather than a proven primary therapy for severe or H. pylori-associated gastritis. ScienceDirect European Medicines Agency (EMA)