Bismuth Subsalicylate, the most commonly encountered form of bismuth, is a mineral that is used in the treatment of upset stomach, diarrhea, or to prevent traveler’s diarrhea. It is also used in the treatment of stomach ulcer and upset stomach associated with infection due to the bacteria Helicobacter pylori. The most common product containing Bismuth Subsalicylate is Pepto Bismol.
Adult dosages for various conditions:
Diarrhea: 525mg (30 milliliters regular liquid or 2 tablets) every 30 minutes to 1 hour, up to a maximum of 8 doses daily, by mouth. Maximum strength liquid: 30 milliliters (1050mg) every 1 hour, for a maximum of 4 doses daily, by mouth.
Upset Stomach, suspension (liquid): 30 milliliters, four times daily, by mouth, for 3 weeks.
Helicobacter Pylori: 265mg (2 tablets), four times daily, by mouth, along with antibiotic therapy.
Indigestion (upset stomach): 525mg (30 milliliters regular liquid or 2 tablets) every 30 minutes to 1 hour up to a maximum of 8 doses daily, by mouth.
Traveler’s Diarrhea: 525mg (30 milliliters regular liquid or 2 tablets) every 30 minutes to 1 hour, up to a maximum of 8 doses daily, by mouth.
Traveler’s Diarrhea prevention: 2 chewable tablets four times daily up to 3 weeks. Begin treatment one day before departure.
Stomach Ulcer: 600mg, three times daily, by mouth.
Children dosages:
Diarrhea, Upset Stomach
3 to 6 years old, suspension (liquid): 5 milliliters (1/3 tablet) every 30 minutes to 1 hour up to a maximum of 8 doses daily, by mouth.
6 to 9 years old, suspension (liquid): 10 milliliters (2/3 tablet) every 30 minutes to 1 hour up to a maximum of 8 doses daily, by mouth.
9 to 12 years old, suspension (liquid): 15 milliliters (1 tablet) every 30 minutes to 1 hour up to a maximum of 8 doses daily, by mouth.
To store this medicine: Keep all medicine locked up and away from children. Store medicine away from heat and direct light. Do not store your medicine in the bathroom, near the kitchen sink, or in other damp places. Heat or moisture may cause the medicine to break down and not work the way it should work. Throw away medicine that is out of date or that you do not need. Never share your medicine with others.
Warnings:
Do not take Bismuth Subsalicylate without talking to your doctor first if you are taking:
Methotrexate.
Gout medicine (example: probenecid, sulfinpyrazone).
Tetracycline antibiotics.
Diabetes medicine (examples: Glucophage(R) metformin, Diabeta(R) Glynase(R) glyburide, Glucotrol(R) glipizide).
Blood thinning medicine.
Before taking Bismuth Subsalicylate, tell your doctor if you are pregnant or breastfeeding.
The maximum daily dose is 4.2 grams.
Do not use in children and teenagers who have, or are recovering from, a cold or a flu.
Do not use if you have any allergies or sensitivity to salicylates or aspirin.
Do not use if you have diabetes, gout, or a bleeding disorder.
Side Effects:
Stop taking your medicine right away and talk to your doctor if you have any of the following side effects. Your medicine may be causing these symptoms which may mean you are allergic to it.
Breathing problems or tightness in your throat or chest.
Chest pain.
Skin hives, rash, or itchy or swollen skin.
Other Possible Side Effects: You may have the following side effects, but this medicine may also cause other side effects. Tell your doctor if you have side effects that you think are caused by this medicine.
May temporary darken tongue or feces.
May cause ringing in the ears.
Upset stomach, throwing up, and constipation (difficulty having bowel movements) have been reported.
Bismuth can help with the following
Microscopic Colitis (Collagenous Colitis / Lymphocytic Colitis)
Thirteen patients with microscopic colitis were treated with 8 chewable 262mg bismuth subsalicylate tablets per day for 8 weeks. Twelve patients completed the trial. Eleven patients had a resolution of their diarrhea and a reduction in fecal weight. The average time to respond was 2 weeks. In 9 patients colitis resolved. Post-treatment follow-up for 7-28 months showed that the 9 patients remained well without treatment, 2 were well but still required treatment and 1 had continued diarrhea. [Gastroenterology 1998;114(1): pp.29-36]
Key
| May do some good |
| Likely to help |
| Highly recommended |
Glossary
Mineral
Plays a vital role in regulating many body functions. They act as catalysts in nerve response, muscle contraction and the metabolism of nutrients in foods. They regulate electrolyte balance and hormonal production, and they strengthen skeletal structures.
Stomach
A hollow, muscular, J-shaped pouch located in the upper part of the abdomen to the left of the midline. The upper end (fundus) is large and dome-shaped; the area just below the fundus is called the body of the stomach. The fundus and the body are often referred to as the cardiac portion of the stomach. The lower (pyloric) portion curves downward and to the right and includes the antrum and the pylorus. The function of the stomach is to begin digestion by physically breaking down food received from the esophagus. The tissues of the stomach wall are composed of three types of muscle fibers: circular, longitudinal and oblique. These fibers create structural elasticity and contractibility, both of which are needed for digestion. The stomach mucosa contains cells which secrete hydrochloric acid and this in turn activates the other gastric enzymes pepsin and rennin. To protect itself from being destroyed by its own enzymes, the stomach’s mucous lining must constantly regenerate itself.
Diarrhea
Excessive discharge of contents of bowel.
Ulcer
Lesion on the skin or mucous membrane.
Bacteria
Microscopic germs. Some bacteria are "harmful" and can cause disease, while other "friendly" bacteria protect the body from harmful invading organisms.
Helicobacter Pylori
H. pylori is a bacterium that is found in the stomach which, along with acid secretion, damages stomach and duodenal tissue, causing inflammation and peptic ulcers. Although most people will never have symptoms or problems related to the infection, they may include: dull, 'gnawing' pain which may occur 2-3 hours after a meal, come and go for several days or weeks, occur in the middle of the night when the stomach is empty and be relieved by eating; loss of weight; loss of appetite; bloating; burping; nausea; vomiting.
Milligram
(mg): 1/1,000 of a gram by weight.
Gout
A disease characterized by an increased blood uric acid level and sudden onset of episodes of acute arthritis.
Diabetes Mellitus
A disease with increased blood glucose levels due to lack or ineffectiveness of insulin. Diabetes is found in two forms; insulin-dependent diabetes (juvenile-onset) and non-insulin-dependent (adult-onset). Symptoms include increased thirst; increased urination; weight loss in spite of increased appetite; fatigue; nausea; vomiting; frequent infections including bladder, vaginal, and skin; blurred vision; impotence in men; bad breath; cessation of menses; diminished skin fullness. Other symptoms include bleeding gums; ear noise/buzzing; diarrhea; depression; confusion.
Gram
(gm): A metric unit of weight, there being approximately 28 grams in one ounce.
Allergy
Hypersensitivity caused by exposure to a particular antigen (allergen), resulting in an increased reactivity to that antigen on subsequent exposure, sometimes with harmful immunologic consequences.
Urticaria
Commonly known as hives, urticaria is one of the most common dermatological conditions seen by allergists. Urticaria is not just an allergic disease, however. It can be caused by metabolic diseases, medications, infectious diseases, autoimmune disease, or physical sensitivity. Traditional allergies to foods or medications as well as viral illness are frequent causes of acute urticaria which usually lasts only a few hours but may last up to 6 weeks. Chronic urticaria (lasting more than 6 weeks) is more complex, given the vast number of potential triggers. Symptoms include sudden onset; initial itching; then swelling of the surface of the skin into red or skin-colored welts (wheals) with clearly defined edges; welts turn white on touching; new welts develop when the skin is scratched; usually disappear within minutes or hours. Welts enlarge, change shape, spread or join together to form large flat raised areas.
Constipation
Difficult, incomplete, or infrequent evacuation of dry, hardened feces from the bowels.