RHUBARB

OTHER NAME(S):

Chinese Rhubarb, Da Huang, Garden Rhubarb, Himalayan Rhubarb, Indian Rhubarb, Medicinal Rhubarb, Radix et Rhizoma Rhei, Rewandchini, Rhapontic Rhubarb, Rhei, Rhei Radix, Rheum australe, Rheum emodi, Rheum officinale, Rheum palmatum, Rheum rhaponticum, Rheum tanguticum, Rhubarbe, Rhubarbe de Chine, Rhubarbe Indienne, Rhubarbe Médicinale, Rhubarbe Palmée, Rhubarbe Potagère, Rhubarbe Turque, Ruibarbo, Siberian Rhubarb, Tai Huang, Turkey Rhubarb. <br/><br/>

Overview

Overview Information

Rhubarb is a plant. The root and underground stem (rhizome) are used to make medicine. The stem of rhubarb is also consumed as food. Traditional Chinese medicine commonly uses rhubarb alone or in combination with other ingredients.

Rhubarb is used primarily for digestive complaints including constipation, diarrhea, heartburn, stomach pain, gastrointestinal (GI) bleeding, and preparation for certain GI diagnostic procedures. Some people use rhubarb to decrease the strain during bowel movements. Rhubarb is also used for gonorrhea, high levels of cholesterol in the blood, high blood pressure associated with pregnancy, and weight loss.

Rhubarb is also used to improve symptoms associated with menopause or menstruation. It is also used to reduce pain associated with pancreas swelling (inflammation) or to slow down kidney disease. Rhubarb is used to reduce symptoms of stroke, sepsis (blood infection), or pesticide poisoning. It is also used for some types of cancer and for patients with nonalcoholic fatty liver disease (NAFLD).

A mouth rinse containing rhubarb is used for gingivitis.

Rhubarb is sometimes applied to the skin to treat cold sores.

In food, rhubarb stems are eaten in pie and other recipes. Rhubarb is also used as a flavoring agent.

How does it work?

Rhubarb contains several chemicals which might help heal cold sores and improve movement of the intestines. Some chemicals in rhubarb might reduce swelling. Rhubarb contains fiber that might reduce cholesterol levels.

Uses

Uses & Effectiveness?

Possibly Effective for

  • Cold sores. Applying a cream containing rhubarb and sage to herpes cold sores seems to improve healing. It might be as effective as acyclovir (Zovirax) cream.
  • Menopause. Clinical research shows that taking a rhubarb root extract by mouth improves many symptoms of menopause, including hot flushes, sweating, sleep, mood, quality of life, fatigue, and sexual problems.
  • Pancreas inflammation (pancreatitis). Rhubarb powder given through a tube directly into the intestines might help to reduce pain and other symptoms of pancreatitis. It might also decrease the length of a hospital stay for pancreatitis.

Insufficient Evidence for

  • Painful menstruation (dysmenorrhea). Early research suggests that taking rhubarb powder might reduce pain during menstruation.
  • Bleeding from the stomach and bowels. There is some evidence that taking rhubarb powder might be useful for treating gastrointestinal (GI) bleeding.
  • High cholesterol. Early research shows that eating ground rhubarb stalk for 4 weeks can lower total cholesterol and low-density lipoprotein (LDL or "bad") cholesterol in people with high cholesterol.
  • Kidney disease. There is not enough reliable information to know if rhubarb helps people with kidney disease. Most studies have measured the effects of rhubarb on markers of kidney disease and the progression of kidney disease to kidney failure. Results are conflicting. Nearly all of the studies are low quality and at high risk of bias.
  • Cancer affecting the area behind the nose (nasopharyngeal cancer). Early research suggests that taking a specific Chinese herbal product (Shenlong) containing rhubarb and other herbs along with radiation therapy does not improve healing in people with nasopharyngeal cancer.
  • Nonalcoholic fatty liver disease (NAFLD). Early research suggests that taking a specific Chinese herbal medicine (Danning Pian) containing rhubarb, giant knotweed, dried green orange peel, and dried old orange peel might improve liver function in people with non-alcoholic fatty liver disease. It's unknown if rhubarb helps if taken by itself.
  • Obesity. Some early research suggests that taking rhubarb extract 1-3 times daily for up to 3 months might reduce body weight in obese people. However, other research shows that taking rhubarb with other herbs does not reduce weight.
  • Poisoning. Exposure to large amounts of pesticides can result in poisoning. In people with pesticide poisoning, early research suggests that taking rhubarb or having rhubarb placed in the rectum as an enema, while also using regular treatments for poisoning, might reduce symptoms and maintain the function of the body.
  • Life-threatening infection (sepsis). Early research suggests that using rhubarb along with standard treatments might help reduce the risk for certain complications from a life-threatening infection called sepsis. But rhubarb doesn't appear to reduce death due to this type of infection.
  • Stroke. Low-quality research suggests that using traditional Chinese medicine that contains rhubarb root and rhizome, in combination with regular stroke treatments, improves function and reduces damage to the brain better than the regular treatments alone in patients who have had a stroke. Higher-quality research is needed to confirm.
  • Diarrhea.
  • Hemorrhoids.
  • Indigestion.
  • Stomach pain.
  • Other conditions.
More evidence is needed to rate the effectiveness of rhubarb for these uses.

Side Effects

Side Effects & Safety

Rhubarb stem is LIKELY SAFE when it is consumed as food. Rhubarb root and rhizome are POSSIBLY SAFE for most adults when taken by mouth in medicinal amounts for up to 2 years. Rhubarb stem is POSSIBLY SAFE when taken by mouth in medicinal amounts for up to 4 weeks.

Rhubarb leaves are POSSIBLY UNSAFE when taken by mouth. Rhubarb leaves contain oxalic acid, which can cause abdominal pain, burning of the mouth and throat, diarrhea, nausea, vomiting, seizures, and death.

Rhubarb can cause some side effects such as stomach and intestinal pain, watery diarrhea, nausea, vomiting, rash, and uterine contractions. Long-term use can result in muscular weakness, bone loss, potassium loss, and irregular heart rhythm.

There is a report of kidney failure in someone who took a product containing rhubarb. But it's not known for sure if rhubarb was the actual cause of kidney failure.

Special Precautions & Warnings:

Pregnancy and breast-feeding: Rhubarb is POSSIBLY UNSAFE when used in amounts greater than those found in foods.

Diarrhea or constipation: Rhubarb can make diarrhea or constipation worse, depending on the preparation used.

Gastrointestinal (GI) conditions: Don't take rhubarb if you have a bowel obstruction; appendicitis; unexplained stomach pain; or inflammatory conditions of the intestines including Crohn's disease, colitis, and irritable bowel syndrome (IBS).

Kidney disease: There is a chemical in rhubarb that might harm the kidneys. In fact, a supplement that contained rhubarb has been linked to one report of kidney failure. If you already have kidney disease, don't risk making it worse by taking rhubarb.

Kidney stones: Rhubarb contains a chemical that the body can convert into kidney stones. If you have ever had kidney stones, don't take rhubarb.

Liver problems: Rhubarb can make liver function worse in people who already have liver problems. People who have liver problems should avoid rhubarb.

Interactions

Interactions?

Moderate Interaction

Be cautious with this combination

!
  • Digoxin (Lanoxin) interacts with RHUBARB

    Rhubarb is a type of laxative called a stimulant laxative. Stimulant laxatives can decrease potassium levels in the body. Low potassium levels can increase the risk of side effects of digoxin (Lanoxin).

  • Medications for inflammation (Corticosteroids) interacts with RHUBARB

    Some medications for inflammation can decrease potassium in the body. Rhubarb is a type of laxative that might also decrease potassium in the body. Taking rhubarb along with some medications for inflammation might decrease potassium in the body too much.<br/><br/> Some medications for inflammation include dexamethasone (Decadron), hydrocortisone (Cortef), methylprednisolone (Medrol), prednisone (Deltasone), and others.

  • Medications taken by mouth (Oral drugs) interacts with RHUBARB

    Rhubarb is a laxative. Laxatives can decrease how much medicine your body absorbs. Decreasing how much medicine your body absorbs can decrease the effectiveness of your medication.

  • Medications that can harm the kidneys (Nephrotoxic Drugs) interacts with RHUBARB

    Taking rhubarb might harm the kidneys in some people. Some medications can also harm the kidneys. Taking rhubarb with medications that can harm the kidneys might increase the chance of kidney damage.<br/><br/> Some of these medications that can harm the kidneys include cyclosporine (Neoral, Sandimmune); aminoglycosides including amikacin (Amikin), gentamicin (Garamycin, Gentak, others), and tobramycin (Nebcin, others); nonsteroidal anti-inflammatory drugs (NSAIDs) including ibuprofen (Advil, Motrin, Nuprin, others), indomethacin (Indocin), naproxen (Aleve, Anaprox, Naprelan, Naprosyn), piroxicam (Feldene); and numerous others.

  • Stimulant laxatives interacts with RHUBARB

    Rhubarb is a type of laxative called a stimulant laxative. Stimulant laxatives speed up the bowels. Taking rhubarb along with other stimulant laxatives could speed up the bowels too much and cause dehydration and low minerals in the body.<br/><br/> Some stimulant laxatives include bisacodyl (Correctol, Dulcolax), cascara, castor oil (Purge), senna (Senokot), and others.

  • Warfarin (Coumadin) interacts with RHUBARB

    Rhubarb can work as a laxative. In some people rhubarb can cause diarrhea. Diarrhea can increase the effects of warfarin and increase the risk of bleeding. If you take warfarin do not to take excessive amounts of rhubarb.

  • Water pills (Diuretic drugs) interacts with RHUBARB

    Rhubarb is a laxative. Some laxatives can decrease potassium in the body. "Water pills" can also decrease potassium in the body. Taking rhubarb along with "water pills" might decrease potassium in the body too much.<br/><br/> Some "water pills" that can decrease potassium include chlorothiazide (Diuril), chlorthalidone (Thalitone), furosemide (Lasix), hydrochlorothiazide (HCTZ, HydroDiuril, Microzide), and others.

Dosing

Dosing

The following doses have been studied in scientific research:

BY MOUTH:

  • For menopause: A specific rhubarb root dry extract (ERr 731, Anderson Global Group) ) 4 mg per day for up to 2 years.
  • For swelling of the pancreas (pancreatitis): Rhubarb powder 15 grams in 100 mL warm water given by a healthcare provider through a tube going directly into the small intestine for up to one week.
APPLIED TO THE SKIN:
  • For cold sores: Cream containing rhubarb extract 23 mg and sage extract 23 mg in every gram of cream, applied every 2 to 4 hours while awake. Treatment starts within one day after symptoms appear and continues for 10 to 14 days.

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  • Yu CP, Lin HJ, Lin SP, Shia CS, Chang PH, Hou YC, Hsieh YW. Rhubarb decreased the systemic exposure of cyclosporine, a probe substrate of P-glycoprotein and CYP 3A. Xenobiotica. 2016 Aug;46(8):677-82. View abstract.
  • Zhang L, Chen J, Jiang D, Zhang P. Adjuvant treatment with crude rhubarb for patients with systemic inflammation reaction syndrome/sepsis: a meta-analysis of randomized controlled trials. J Crit Care. 2015 Apr;30(2):282-9. View abstract.

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