How does Pepto Bismol work?

I figured this would be easy enough to Google, but almost all the links are to WebMD-type indications/side effects pages or to this widely copied note:

(as at )

Which is fine for stomach ulcers and H. pylori, but what about diarrhea? Is it the bacteria-killing properties that wipes out diarrhea-causing bacteria? Or does it have some other action in the intestines?

According to

I find Pepto doesn’t work for me - it makes me feel sicker. My MIL also has this problem. She said she only took Pepto twice in her life, and each time she vomited shortly after. When she took something else like Gravol though, she felt better.
I wonder if some people have more or different bacteria in the stomach that have an adverse reaction to the active ingredients in the Pepto?

Wow! who’da thunk it? Great link.

Pink Bismuth has been used for treating stomach aliments & the “trots” since the 19th Century, at least.

It is probably worth noting that some anti-diarheal meds work by slowing the contractions in the intestines. This allows time for absorbtion. Basically, your sick body is trying to push millions of bacteria out of your system, and doing it so quickly that fluids are not absorbed (explains the bathroom fun). Most anit-diarhea drugs slow the contractions, and allow the fluids to be absorbed.

While the sympton is treated, the conseuquence is that your body is not rapidly flushing out millions of bacteria. But most people are happy to avoid the bathroom…if they can get there.

OK, bismuth subsalicylate does treat diarhea, but did you know that it also neutralizes, ahem, residual bathroom odor? This is purely anectodal. I noticed this side effect quite by accident.

Here’s the kicker - this works with an ileostomy. I don’t use it regularly, but if I’m going to be with other people, I do take it so I’m not embarrassed.

I’ve long wonderred it people with normal plumbing also notice this. And I’m very curious about how this works. Perhaps it’s the bactericidal action, but that’s just a guess. If that’s so, wouldn’t it also work for people *with * colons?

Expanding the inquiry into bismuth …

Could you just swallow elemental bismuth and experience the same effects? (Note: I am not going to do this. Just curious.)

And Immodium worked for my mom that way too. I once told her that I thought I was over the recommended dose and she told me that she had taken twice that amount at times.

Of course, she had terminal colon cancer so she wasn’t really too worried about side effects.

The bismuth in pepto is oxidized. I’m also not sure if it’s the whole complex that’s important or not (it may dissociate.) I’d say no.
I can’t find an MSDS that has much toxicological info, but I doubt it’s good for you.

Well, strangely enough, PB also tends to settle “queasy” stomach. At least for me. I’ve been under the impression that the reasons were not well understood. I’m fine with that. Ignorance and comfort beat discomfort any day. xo, C.