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Rhubarb leaves poisoning

Rheum officinale poisoning

Rhubarb leaves poisoning occurs when someone eats pieces of leaves from the rhubarb plant.

This article is for information only. DO NOT use it to treat or manage an actual poison exposure. If you or someone you are with has an exposure, call your local emergency number (such as 911), or your local poison control center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States.

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Poisonous Ingredient

Poisonous ingredients include:

• Anthraquinone glycosides (possible)
• Oxalic acid

Where Found

These substances are found in the leaves (leaf blade) of the rhubarb plant. The stalk can be eaten.

Symptoms

Symptoms may include:

• Breathing difficulty
• Blisters in the mouth
• Burning in mouth and throat
• Coma (unconsciousness, lack of responsiveness)
• Diarrhea
• Hoarse voice
• Increased saliva production
• Nausea and vomiting
• Kidney stones (flank and back pain)
• Red-colored urine
• Seizures (convulsions)
• Stomach pain
• Weakness

Blistering and swelling in the mouth may be severe enough to prevent normal speaking and swallowing.

Home Care

Seek immediate medical help. DO NOT make a person throw up unless told to do so by poison control or a health care provider. Flush the skin and eyes with lots of water, if the plant touched these areas.

Before Calling Emergency

Get the following information:

• Person's age, weight, and condition
• Name of the plant, if known
• Time it was swallowed
• Amount swallowed

Poison Control

Your local poison control center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States. This national hotline will let you talk to experts in poisoning. They will give you further instructions.

This is a free and confidential service. All local poison control centers in the United States use this national number. You should call if you have any questions about poisoning or poison prevention. It does not need to be an emergency. You can call for any reason, 24 hours a day, 7 days a week.

What to Expect at the Emergency Room

The provider will measure and monitor the person's vital signs, including temperature, pulse, breathing rate, and blood pressure. Symptoms will be treated as appropriate. The person may receive:

• Activated charcoal
• Breathing support, including oxygen through a tube through the mouth into the lungs, and a breathing machine (ventilator)
• Blood and urine tests
• Chest x-ray
• ECG (electrocardiogram, or heart tracing)
• Fluids by IV (through the vein)
• Laxatives
• Medicines to treat symptoms

Outlook (Prognosis)

How well you do depends on the amount of poison swallowed and how quickly treatment is received. The faster you get medical help, the better the chance for recovery.

Symptoms last for 1 to 3 days and may require a hospital stay.

Serious poisonings can result in kidney failure. Deaths have been reported, but are rare.

DO NOT touch or eat any plant with which you are not familiar. Wash your hands after working in the garden or walking in the woods.

References

Graeme KA. Toxic plant ingestions. In: Auerbach PS, Cushing TA, Harris NS, eds. Auerbach's Wilderness Medicine. 7th ed. Philadelphia, PA: Elsevier; 2017:chap 65.

Ryan ET, Hill DR, Solomon T, Aronson NE, Endy TP. Poisonous plants and aquatic animals. In: Ryan ET, Hill DR, Solomon T, Aaronson NE, Endy TP, eds. Hunter's Tropical Medicine and Emerging Infectious Diseases. 10th ed. Philadelphia, PA: Elsevier; 2020:chap 139.

Review Date: 11/2/2023  

Reviewed By: Jesse Borke, MD, CPE, FAAEM, FACEP, Attending Physician at Kaiser Permanente, Orange County, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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