From the Guidelines
Yes, Pepto Bismol (bismuth subsalicylate) can be given for abdominal pain associated with diarrhea, as it is mildly effective in reducing symptoms, according to the 2017 Infectious Diseases Society of America clinical practice guidelines for the diagnosis and management of infectious diarrhea 1. The standard adult dosage is two tablets (525 mg) or 30 mL of liquid every 30-60 minutes as needed, not exceeding 8 doses in 24 hours, for up to 2 days. For children 9-12 years old, the dose is one tablet or 15 mL, while children under 9 should only take it under medical supervision. Pepto Bismol works by coating the stomach lining, reducing inflammation, and has mild antibacterial properties that can help with certain causes of diarrhea. It also decreases intestinal secretions and slows gut motility, which helps reduce diarrhea and associated pain. However, it should not be given to individuals with aspirin allergies, bleeding disorders, or those taking blood thinners due to its salicylate content. It's also not recommended for children and teenagers with flu-like symptoms or chickenpox due to the risk of Reye's syndrome. If symptoms persist beyond 2 days or are accompanied by high fever or bloody stools, medical attention should be sought. Some key points to consider when using Pepto Bismol for abdominal pain associated with diarrhea include:
- The medication should only be used for a short period, up to 2 days, as prolonged use can lead to salicylate toxicity 1.
- Patients with certain medical conditions, such as kidney or liver disease, should use Pepto Bismol with caution and under medical supervision 1.
- The medication may interact with other medications, such as blood thinners, and decrease their effectiveness 1.
- Pepto Bismol is not recommended for use in children under 3 years old, as it can increase the risk of Reye's syndrome 1.
- Patients should be advised to seek medical attention if their symptoms worsen or do not improve within 2 days of treatment 1.
From the Research
Pepto Bismol for Abdominal Pain due to Diarrhea
- Pepto Bismol, also known as bismuth subsalicylate, can be used to treat abdominal pain due to diarrhea, as it has been shown to provide subjective relief from symptoms such as abdominal pain or cramps 2.
- Studies have demonstrated that bismuth subsalicylate can decrease the number of unformed stools and provide relief from diarrhea, nausea, and abdominal pain or cramps 2, 3.
- The medication has been found to be effective against infectious gastroenteritis, including travelers' diarrhea, and can reduce the risk of inappropriate antibiotic utilization 3.
- Bismuth subsalicylate has been compared to other treatments, such as loperamide, and while it may not provide faster relief, it has the advantage of being safe for use in all patients with travelers' diarrhea 4.
Efficacy of Bismuth Subsalicylate
- A systematic review and meta-analysis found that subjects treated with bismuth subsalicylate had 3.7 times greater odds of diarrhea relief compared to those receiving a placebo 3.
- Another study found that bismuth subsalicylate significantly reduced the number of unformed stools and increased the proportion of patients free of symptoms at the end of the trial 4.
- The medication has been shown to be effective in reducing the duration and severity of diarrhea, as well as providing relief from associated symptoms such as abdominal pain and nausea 2, 3.