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Rhubarb

Rhubarb is a plant whose root stem and root are used to make medicine. Rhubarb is primarily used to treat digestive tract complaints including constipation, diarrhea, heartburn, stomach pain and bleeding in the stomach and intestines, as well as to prepare for certain diagnostic procedures in the digestive tract. Some people use rhubarb to reduce the need to push hard during bowel movements, reducing pain from hemorrhoids or cracks in the anal canal (anal fissures). Rhubarb is sometimes applied to the skin to treat cold sores. In food, the stalks of rhubarb are used as an ingredient in cakes and other recipes. Rhubarb is also used as a flavoring agent.

How does rhubarb work?

Rhubarb contains several chemicals that may help heal cold sores.

How effective is rhubarb?

Rhubarb may be effective in combination with sage in treating cold sores. There is not enough scientific data to make a statement about the effectiveness of rhubarb for bleeding in the stomach and intestines. There are indications that the intake of rhubarb powder could be useful in the treatment of bleeding in the digestive tract. There is also insufficient information on the effectiveness of rhubarb for stomach upsets, stomach pain, hemorrhoids, constipation and diarrhea. Further scientific research is needed to evaluate the effectiveness of rhubarb in these applications.

Safety and side effects

Rhubarb is probably safe and harmless when consumed as a food. It is potentially safe and harmless for most people when taken orally in medicinal quantities for up to 8 days. Rhubarb can cause some side effects such as pain in the stomach and intestines, watery diarrhea and uterine contractions. Long-term use may result in muscle weakness, bone loss, potassium loss and irregular heartbeat. There is one reported case of kidney failure in a person who ingested a product containing rhubarb. However, it is not known whether rhubarb was actually the cause of the kidney failure. Rhubarb may not be safe and harmless for children. There is a report of a four-year-old boy who died after eating rhubarb leaves. Rhubarb leaves contain oxalic acid, which can be fatal in high doses. Due to their small size, children are at a higher risk of oxalic acid poisoning after eating rhubarb leaves.

Precautions and warnings

Pregnancy and breastfeeding: Rhubarb may not be safe and harmless if used in quantities exceeding normal dietary amounts.

Diarrhea or constipation: Rhubarb products may aggravate diarrhea or constipation depending on the preparation used.

Digestive tract disorders: Rhubarb products should not be used if you suffer from intestinal constipation, appendicitis, unexplained stomach pain or inflammatory bowel disease including Crohn's disease and irritable bowel syndrome.

Kidney diseases: Rhubarb contains a chemical that could damage the kidneys. A supplement containing rhubarb has been linked to a case of kidney failure. For this reason, if you suffer from kidney disease, you should avoid rhubarb to be on the safe side.

Kidney stones: Rhubarb contains a chemical that can be converted by the body into kidney stones. For this reason, you should avoid rhubarb if you suffer from kidney stones.

Interactions

You should be careful when combining rhubarb products with the following medications.

Anti-inflammatory drugs (corticosteroids)

Some anti-inflammatory drugs can lower potassium levels in the body. Rhubarb is a type of laxative that could lower potassium levels in the body. Taking rhubarb products in conjunction with certain anti-inflammatory medications could lower potassium levels in the body too much.

Medication taken orally

Rhubarb is a laxative. Laxatives can reduce the amount of active drug ingredients absorbed by the body. Such a reduction in absorption can reduce the effectiveness of these drugs.

Medications that can damage the kidneys

The intake of rhubarb products could damage the kidneys in some people. Some medications can also damage the kidneys. Taking rhubarb products in combination with medications that can damage the kidneys could increase the risk of kidney damage.

Stimulating laxatives

Rhubarb is a type of laxative called a stimulant laxative. Stimulant laxatives speed up the passage of food through the intestines. Taking rhubarb products in combination with other stimulant laxatives could increase the passage of food through the intestines too much and result in dehydration and low mineral levels in the body.

Diuretics

Rhubarb is a laxative. Some laxatives can lower potassium levels in the body. Diuretics can also lower potassium levels, which means that the combination of rhubarb with diuretics could lower potassium levels in the body too much.

Dosage

The following dosages have been investigated in scientific studies:

Applied to the skin

  • For the treatment of cold sores: a cream containing 23 mg each of rhubarb extract and sage extract is applied to the skin every 2 to 4 hours, starting on the first day of the onset of symptoms and continuing for 10 to 14 days.

References

  1. Jiao DH, Ma YH, Chen SJ, et al. Resume of 400 cases of acute upper digestive tract bleeding treated by rhubarb alone. Pharmacology 1980;20 Suppl 1:128-30.
  2. Kwan TH, Tong MK, Leung KT, et al. Acute renal failure associated with prolonged intake of slimming pills containing anthraquinones. Hong Kong Med J 2006;12:394-7.
  3. Nusko G, Schneider B, Schneider I, et al. Anthranoid laxative use is not a risk factor for colorectal neoplasia: results of a prospective case control study. Gut 2000;46:651-5.
  4. Saller R, Buechi S, Meyrat R, Schmidhauser C. Combined herbal preparation for topical treatment of Herpes labialis. Forsch Komplementarmed Klass Naturheilkd 2001;8:373-82.