Effects of bismuth subsalicylate: A Synthesis of Findings from 26 Studies

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Original Abstract of the Article

Major Research Findings

Bismuth subsalicylate has been shown to be effective in treating acute diarrhea. 1 A double-blind, placebo-controlled study of 123 children hospitalized with acute diarrhea found that those treated with bismuth subsalicylate had a significant decrease in stool frequency and weight, improvement in stool consistency, a significant improvement in clinical well-being, and a shorter duration of the illness. The study also found that bismuth subsalicylate was well tolerated and associated with clearance of pathogenic Escherichia coli from the stools in 100% of cases.

Bismuth subsalicylate has also been studied for its use in treating Helicobacter pylori infection. 24 Helicobacter pylori infection is a common cause of gastritis, peptic ulcers, and gastric cancer. While standard triple regimens for treating Helicobacter pylori have been used, these have shown declining efficacy, prompting the search for alternative treatments. Research suggests that bismuth-based quadruple and concomitant therapies may be effective in treating Helicobacter pylori.

Some studies suggest that bismuth subsalicylate may protect the gastric mucosal barrier. 14 The gastric mucosal barrier is a protective layer that helps prevent harmful substances from entering the body. While bismuth subsalicylate has not been shown to protect the gastric mucosal barrier from the effects of alcohol, more research is needed to determine its potential role in protecting the gastric mucosal barrier.

Bismuth subsalicylate has also been studied for its potential to reduce methane production in cattle. 6 Methane is a potent greenhouse gas that contributes to climate change. While bismuth subsalicylate did not show a reduction in methane production in cattle, it is a promising area for further research.

Bismuth subsalicylate has also been shown to increase intracellular calcium, MAP-kinase activity, and cell proliferation in normal human gastric mucous epithelial cells. 11 This suggests that bismuth subsalicylate may have additional beneficial effects on the stomach, beyond its antibacterial properties.

Benefits and Risks

Benefits Summary

Bismuth subsalicylate has been shown to be effective in treating acute diarrhea. 1 Bismuth subsalicylate is also used to treat Helicobacter pylori infections. 24 Research suggests that bismuth subsalicylate may protect the gastric mucosal barrier. 14 Bismuth subsalicylate is also being studied for its potential to reduce methane production in cattle. 6 Bismuth subsalicylate may also have additional beneficial effects on the stomach. 11

Risks Summary

While bismuth subsalicylate is generally considered safe, it can cause side effects in some people. These side effects may include constipation, nausea, vomiting, and abdominal pain. 1 Bismuth subsalicylate can also increase the effects of anticoagulant medications such as warfarin. 3 Consult a doctor before using bismuth subsalicylate if you are pregnant, breastfeeding, or taking any other medications.

Comparison of Studies

Commonalities Between Studies

Many studies have shown that bismuth subsalicylate is effective in treating acute diarrhea and Helicobacter pylori infection. 1 24 7 Several studies suggest that bismuth subsalicylate may protect the gastric mucosal barrier. 14 Additionally, bismuth subsalicylate has shown promise in reducing methane production in cattle. 6 15

Differences Between Studies

The effectiveness and safety of bismuth subsalicylate can vary from study to study. 1 24 7 14 6 15 Recommendations for the use of bismuth subsalicylate can also differ. 1 3 These variations may be due to differences in the study populations, the doses of bismuth subsalicylate used, and the study design.

Consistency and Inconsistencies in the Results

While many studies have shown that bismuth subsalicylate is effective in treating acute diarrhea and Helicobacter pylori infection, there is some variation in the effectiveness and safety of the drug. 1 24 7 14 6 15 This inconsistency may be due to differences in the study populations, the doses of bismuth subsalicylate used, and the study design.

Cautions in Applying the Findings to Daily Life

Bismuth subsalicylate is an effective medication for treating acute diarrhea. 1 However, it can cause side effects in some people. 1 Bismuth subsalicylate can also increase the effects of anticoagulant medications such as warfarin. 3 If you are considering using bismuth subsalicylate, talk to your doctor to make sure it is the right medication for you.

Limitations of Current Research

More research is needed to better understand the effects of bismuth subsalicylate. 1 24 7 14 6 15 In particular, more research is needed on the long-term effects of bismuth subsalicylate, the safe dosage, and interactions with other medications.

Future Research Directions

Further research is needed to better understand the effects of bismuth subsalicylate. 1 24 7 14 6 15 Specifically, more research is needed on the long-term effects of bismuth subsalicylate, the safe dosage, and interactions with other medications.

Conclusion

Bismuth subsalicylate may be an effective medication for treating acute diarrhea and Helicobacter pylori infection. 1 24 7 However, it can cause side effects in some people. 1 Bismuth subsalicylate can also increase the effects of anticoagulant medications such as warfarin. 3 If you are considering using bismuth subsalicylate, talk to your doctor to make sure it is the right medication for you.

Literature analysis of 26 papers
Positive Content
22
Neutral Content
2
Negative Content
2
Article Type
11
1
2
2
26
1.

Bismuth subsalicylate in the treatment of acute diarrhea in children: a clinical study.

Author: Soriano-BrücherH, AvendañoP, O'RyanM, BraunS D, ManhartM D, BalmT K, SorianoH A

Clear E. coli
Improve stool consistency
Reduce hospital stay
Reduce stool frequency
Shorten disease duration
No reported adverse effects

Bismuth subsalicylate provided effective adjunctive therapy for acute diarrhea, allowing children to get well sooner with less demand on the nursing and hospital staff.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

2.

[Addition of bismuth subsalicylate to triple eradication therapy for Helicobacter pylori infection: efficiency and adverse events].

Author: Hinostroza MoralesDennis, Díaz FerrerJavier

Effective eradication
Abdominal pain
Dark feces
Diarrhea

This study found that the addition of bismuth subsalicylate to triple eradication therapy for Helicobacter pylori infection was effective in 89.7% of patients, whereas 80% of patients receiving the standard triple therapy achieved eradication. The most common side effects were diarrhea, dark feces, and abdominal pain.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : Spanish

3.

Inadvertent exaggerated anticoagulation following use of bismuth subsalicylate in an enterally fed patient receiving warfarin therapy.

Author: BinghamAngela L, BrownRex O, DickersonRoland N

Increased INR

This case report describes a patient receiving warfarin therapy who experienced an inadvertent increase in INR after the addition of bismuth subsalicylate for the treatment of diarrhea. The report highlights the potential for a drug interaction between warfarin and bismuth subsalicylate, emphasizing the importance of avoiding concurrent use of these medications.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

4.

Mucoadhesive effect of Curcuma longa extract and curcumin decreases the ranitidine effect, but not bismuth subsalicylate on ethanol-induced ulcer model.

Author: Orona-OrtizAlejandra, Medina-TorresLuis, Velázquez-MoyadoJosué A, Pineda-PeñaElizabeth A, Balderas-LópezJosé Luis, Bernad-BernadMaría Josefa, Tavares CarvalhoJosé Carlos, NavarreteAndrés

Ulcer treatment
Drug interaction

This study investigated the pharmacological interactions of turmeric acetone extract (TAE) and curcumin with ranitidine and bismuth subsalicylate in an ethanol-induced ulcer model in rats. The combinations showed subadditive or additive interactions, suggesting potential interference with ranitidine's effectiveness.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

5.

Seven-Day Bismuth-based Quadruple Therapy as an Initial Treatment for Helicobacter pylori Infection in a High Metronidazole Resistant Area.

Author: VilaichoneRatha-korn, PrapitpaiboonHatainuch, GamnaraiPornpen, NamtaneeJuraiwan, Wongcha-umArti, ChaithongratSupakarn, MahachaiVarocha

Effective treatment
Safe treatment
Drug resistance

Metronidazole-resistant H. pylori is prevalent in Thailand, making eradication therapy difficult. This study evaluated the efficacy and safety of a 7-day bismuth-based quadruple therapy including metronidazole for H. pylori infection in a region with high resistance.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

7.

The efficacy of bismuth containing quadruple therapy as a first-line treatment option for Helicobacter pylori.

Author: UygunAhmet, KadayifciAbdurrahman, SafaliMukerrem, IlganSeyfettin, BagciSait

H. pylori eradication
Side effects

This study found that a bismuth-based quadruple regimen achieved a better eradication rate compared with proton pump inhibitor-based triple regimens as a first-line eradication option for H. pylori.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

8.

Anti-inflammatory and tissue-protectant drug effects: results from a randomized placebo-controlled trial of gastritis patients at high risk for gastric cancer.

Author: FischbachL A, CorreaP, RamirezH, RealpeJ L, CollazosT, RuizB, BravoL E, BravoJ C, CasabonA L, SchmidtB A

Anti-inflammatory
Tissue protectant

Tetracyclines may offer anti-inflammatory and tissue-protectant benefits in Helicobacter pylori-associated gastritis, potentially mitigating the negative impacts of the infection.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
Research Support, U.S. Gov't, P.H.S.Research funding provided by the Public Health Service (PHS).

Language : English

9.

Update on Helicobacter pylori treatment.

Author: AblesAdrienne Z, SimonI, MeltonEmily R

H. pylori eradication
Patient compliance
Rebleeding reduction
Recurrence reduction
Ulcer healing
Antisecretory medication
Endoscopy
Nonulcer dyspepsia

Eradication of Helicobacter pylori infection is recommended for patients with duodenal or gastric ulcers, with a 'test-and-treat' strategy for undifferentiated dyspepsia. Short-course treatment regimens for H. pylori eradication, such as one-day treatment, have shown promising eradication rates and potentially improved patient compliance.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

11.

Bismuth subsalicylate increases intracellular Ca2+, MAP-kinase activity, and cell proliferation in normal human gastric mucous epithelial cells.

Author: GilsterJason, BaconKathy, MarlinkKatie, SheppardBrett, DeveneyClifford, RuttenMichael

Gastric cell growth
Gastric ulcer healing

Bismuth subsalicylate (BSS) is a medication used to treat stomach ulcers. This study investigated the mechanism by which BSS may promote the growth of gastric epithelial cells.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

13.

Renal pigmentation due to chronic bismuth administration in a rhesus macaque (Macaca mulatta).

Author: JohnsonA L, BlaineE T, LewisA D

Renal pigmentation

This report describes renal pigmentation and intranuclear inclusions in a rhesus macaque due to chronic bismuth administration, highlighting the potential for bismuth toxicity.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.

Language : English

14.

Evaluation of effects of ethyl alcohol and bismuth subsalicylate on gastric mucosal barrier in man.

Author: DyR M, LofJ, DiBaiseJ K, QuigleyE M

Protect gastric mucosa

A distinct pH gradient between gastric luminal fluid and the mucus gel layer exists, and neither bismuth subsalicylate nor ethyl alcohol significantly affects this gradient.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

15.

Effects of bismuth subsalicylate and calcium-ammonium nitrate on ruminal in vitro fermentation of bahiagrass hay with supplemental molasses.

Author: HenryD D, CiriacoF M, AraujoR C, Garcia-AscolaniM E, FontesP L P, OosthuizenN, SanfordC D, SchulmeisterT M, Ruiz-MorenoM, LambG C, DiLorenzoN

Beef production efficiency

Bismuth subsalicylate (BSS) and calcium-ammonium nitrate (CAN) are feed additives that can potentially improve beef production efficiency. In vitro studies show that BSS decreased hydrogen sulfide production without impeding fermentation, while CAN reduced methane production.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled Trial, VeterinaryRandomized controlled trials involving animals. They evaluate the efficacy and safety of treatment methods.

Language : English

16.

Systematic Review and Meta-Analyses Assessment of the Clinical Efficacy of Bismuth Subsalicylate for Prevention and Treatment of Infectious Diarrhea.

Author: BrumJose M, GibbRoger D, RamseyDavid L, BalanGuhan, YacyshynBruce R

Relief of gastrointestinal symptoms

Bismuth subsalicylate is a common medication used to relieve diarrhea and vomiting caused by acute gastroenteritis. It is effective for short-term treatment of travelers' diarrhea.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

17.

Efficacy of two-week therapy with doxycycline-based quadruple regimen versus levofloxacin concomitant regimen for helicobacter pylori infection: a prospective single-center randomized controlled trial.

Author: AlhalabiMarouf, AlassiMohammed Waleed, Alaa EddinKamal, ChehaKhaled

Treat H. pylori

This study compares the effectiveness of doxycycline-based quadruple regimen and levofloxacin concomitant regimen for treating Helicobacter Pylori infections in Syrian population.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

18.

[Effects of fluid shear stress time on carbonic anhydrase in rat osteoclasts].

Author: ZhuBao-min, ZhangQing-hong, WangWei-qian

None mentioned
None mentioned

Fluid shear stress increased mRNA level of carbonic anhydrase II in rat osteoclasts, reaching a peak value at 30 minutes. Further studies are needed to investigate the mechanism.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : Chinese

19.

High Efficacy of Levofloxacin-Dexlansoprazole-Based Quadruple Therapy as a First Line Treatment for Helicobacter pylori Eradication in Thailand.

Author: PrapitpaiboonHatainuch, MahachaiVarocha, VilaichoneRatha-Korn

H. pylori eradication

A levofloxacin-dexlansoprazole-based quadruple therapy was effective in eradicating Helicobacter pylori in Thailand.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

20.

Current Status of Five Different Regimens for Empiric First-Line Helicobacter pylori Eradication in Turkey.

Author: GungorGokhan, BaglıcakogluMurat, KayacetinErtugrul, BiyikMurat, UcarRamazan, GoktepeHakan, AtasevenHuseyin, DemirAli

H. pylori eradication
Side effects

A study comparing the efficacy and tolerability of five different regimens for Helicobacter pylori eradication found that the concomitant and sequential therapies were effective treatments for H. pylori. Bismuth-containing therapy was superior to conventional triple therapies.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

21.

Increased reflux symptoms after calcium carbonate supplementation and successful anti-Helicobacter pylori treatment.

Author: FischbachLori A, CorreaPelayo, FeldmanMark, FonthamElizabeth, PriestElisa, GoodmanKaren J, JainRajeev

Helicobacter pylori treatment
Reflux symptoms

In a study of nonulcer dyspepsia patients, the absence of Helicobacter pylori after treatment with calcium carbonate was associated with an increased risk of reflux symptoms, particularly in those with multifocal atrophic gastritis.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Evaluation StudyResearch that systematically evaluates the effectiveness of a particular program or policy. It measures its outcomes and provides important information for future decision-making.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
Research Support, U.S. Gov't, P.H.S.Research funding provided by the Public Health Service (PHS).

Language : English

22.

The antimicrobial spectrum of Xeroform<sup>&#174;</sup>.

Author: BarilloDavid J, BarilloAnthony R, KornSarah, LamKan, AttarPaul S

Burn wound care

Xeroform, a petrolatum-based gauze with 3% bismuth tribromophenate, has been used for decades in burn and plastic surgery. This study investigated its antimicrobial efficacy against common burn pathogens in vitro using zone-of-inhibition methodology.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

23.

Gastrointestinal Prophylaxis in Sports Medicine.

Author: PatelAkash R, OhebDaniel, ZaslowTracy L

Gastrointestinal infections
Traveler's diarrhea

Traveler’s diarrhea is a common problem for athletes who travel internationally. This article discusses strategies for preventing traveler’s diarrhea in athletes.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

24.

Comparison of bismuth-containing quadruple and concomitant therapies as a first-line treatment option for Helicobacter pylori.

Author: KadayifciAbdurrahman, UygunAhmet, PolatZülfikar, KantarcioğluMurat, KılcılerGüldem, BaşerOmer, OzcanAyhan, EmerOzdeş

H. pylori eradication
Side effects

This randomized study compared the efficacy of bismuth-based quadruple and concomitant regimens in 200 patients with Helicobacter pylori infection. Both regimens achieved moderate eradication rates, with the bismuth-based regimen achieving a slightly better eradication rate but not statistically significant.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

26.

Diarrhoea in adults (acute).

Author: de BruynGuy

Oral rehydration
Treats acute diarrhea
Antibiotic resistance

This systematic review provides information on the effectiveness and safety of various treatments for acute diarrhea, including antibiotics, antimotility agents, antisecretory agents, bismuth subsalicylate, diet, rehydration therapies, and oral rehydration solutions.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

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