Efficacy of Rhubarb ( <i>Rheum ribes</i> L.) Syrup in Children with Acute Diarrhea: A Randomized, Double-Blind Clinical Trial

Background: Diarrhea is a leading cause of death in infans and children. This study aimed to evaluate the efficacy of rhubarb syrup in improving acute diarrhea in children. Methods: This double-blind clinical trial was conducted on 1-6-year-old children with acute viral diarrhea referred to Amirkola Children’s Hospital, Babol, Iran, from October 2021 to October 2022. Children were randomly divided into two groups- the intervention group (rhubarb syrup) and the placebo group- and were treated and followed up for 2 weeks. The primary outcome was the number of loose stools, and the secondary outcome was the length of hospital stay and recovery from acute diarrhea. Intention-to-treat (ITT), log-rank tests, and generalized estimating equation (GEE) were used to analyze the data. A significant level of P&lt;0.05 was set for the present study. Results: Totally, 96 children were included in the study (two groups of 48 individuals). After the intervention, no statistically significant difference was found in mean diarrhea frequency between the two study groups (P=0.809; CI=0.752-1.895), but the mean frequency of diarrhea at discharge was significantly lower in both groups than at the beginning of the hospital stay (P&lt;001). Statistically, no significant difference was observed between the study groups in the duration of recovery from the start of treatment (P=0.296; CI=2.71-3.28) and the number of hospitalization days (P=0.193). Three cases of gastrointestinal complications occurred in the rhubarb syrup group and one case of skin complications occurred in the placebo group, which was not statistically significant (P=0.242; P=1.0, respectively). Conclusion: The results of the study show that rhubarb syrup has no significant effect on the treatment of acute viral diarrhea, despite its minor side effects.