Rhubarb leaves poisoning

Poisonous ingredients include:

• Anthraquinone glycosides (possible)
• Oxalic acid

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

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.

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.

Get the following information:

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

The 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.

You can also get online poison help now at Poisonhelp.org. Just enter the product, poison, or medicine to get expert help.

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:

Tests that may be done include:

• Blood and urine tests
• Chest x-ray
• Electrocardiogram (ECG)

Treatment may include:

• Activated charcoal
• Breathing support, including tube through the mouth into the lungs and connected to a breathing machine (ventilator)
• Fluids through a vein (by IV)
• Laxatives
• Medicine to treat the effects of the poison and other symptoms
• Surgery to remove burned skin (debridement)
• Tube through the mouth into the stomach to wash out the stomach (gastric lavage)
• Washing of the skin (irrigation), every few hours or for several days

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.

Rheum officinale poisoning

Auerbach PS, Constance BB, Freer L. Toxic plants. In: Auerbach PS, Constance BB, Freer L, eds. Field Guide to Wilderness Medicine. 5th ed. Philadelphia, PA: Elsevier; 2019:chap 40.

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.

Meehan TJ. Care of the poisoned patient. In: Walls RM, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 135.

Nelson LS, Calello DP. Acute poisoning. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 96.

Theobald JL, Corcoran JN. Poisoning. In: Kliegman RM, St. Geme JW, Blum NJ, et al, eds. Nelson Textbook of Pediatrics. 22nd ed. Philadelphia, PA: Elsevier; 2025:chap 94.

Updated 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.