Rheum officinalis
(Rhubarb)

Therapeutic Actions:

• Improves uremic indices significantly
• Cholinergic action in rodent studies
• Increases gastric secretion in low doses and acts as an appetite stimulant
• Increases bile secretion
• Powerful antispasmodic in isolated rat intestine - emodin constituent
• Decreases blood glucose in animal studies
• Lowers cholesterol and triglycerides levels in chronic kidney failure
• Mild stimulating tonic to the liver, gall bladder and alimentary mucous membranes
• Suppresses secretion of hepatitis B virus surface antigen in vitro
• Purgative properties in large doses due to the anthraquinone constituents followed by an astringent action making it a good herb to thoroughly cleanse the gastrointestinal tract
• Astringent due to the tannin constituents
• Anti cancer activity due to emodin
• Antibacterial

Clinical Indications:

• Cholelithiasis
• Jaundice
• Constipation
• Diabetic nephropathy
• Gallbladder diseases
• Liver diseases
• Nephritis

Contraindications:

• Pregnancy due to the uterine stimulant activity (although some research has shown rhubarb to be beneficial to pregnant women with hypertension)
• Prolonged use of large doses could cause loss of electrolytes including potassium
• Intestinal obstruction due to the anthraquinone effects
• Lactating women
• Inflammatory disorders, including Crohn's, ulcerative colitis, appendicitis, iritable bowel, may be aggrevated by the irritating effects of anthraquinone constituents
• Kidney problems although there is evidence that the whole herb can help prevent kidney damage or prolong kidney function when damaged

Drug/Nutrient Interaction:

• Prolonged use may lead to potassium depletion leading to the increased toxic effects of cardiac glycosides, including Adonis, Convallaria, Digitalis, Helleborus, Strophanthus and Urginea
• Theoretically any oral drug may have reduced absorption due to decreased bowel transit time
• May enhance the effects of potassium-depleting diuretics

Chemical Constituents:

• Anthraquinones, including emodin, aloe-emodin, chrysophanic acid, rhein and physcion with their O-glycosides - sennosides A, B, C, D, E and F, glucorhein, chrysophanein and glucoemodin (which gives the herb a purgative effect)
• Bitters (which have a gentle tonic bitter effect and aperitive effect in small doses)
• Stilbene derivatives
• Rutin
• Tannins: d-catechin and epicatechin gallate with various coumaroyl galloyl glucosides and fructoses (which gives the herb an astringent effect)
• Volatile oil containing cinnamic, diisobutyl phthalate and ferulic acids
• Note: Constituents may turn urine reddish brown or yellowish brown

Toxicity:

• No known toxicity of rhubarb if use is prescribed by a qualified physician

Copyright 1998 - 2008 by L. Vicky Crouse, ND and James S. Reiley, ND. All rights reserved (ISSN 1527-0661).