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Discussion Starter · #1 ·
Hello, im still struggling on a daily basis with my ibs. Just finished another round of rifaximin but idk how much good it will do.

I know that there was one clinical study that mentioned somewhat positive results in symptoms after taking like 6-8 pepto bismol pills per day for 12 weeks or something. I do not remember all the details, but has daily pepto bismol helped any of you? I have not ever committed to taking it on a schedule, but when I have taken it intermittently, it seems to cause some pretty bad rebound diarrhea.

I know we all react to meds differently, but just looking for positive or negative experiences.
 

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I recently tried this due to really bad excessive gas. I read bismuth helps to kill bacteria. So I would take a swish of the liquid about 30 minutes before I ate. I think it might have helped minimallly. But I guess that is better than nothing. Only change in bowels I saw was my stools became black...which is normal for bismuth. I never had rebound diarrhea though.

I just had 10 days of Cipro to help with gas. Its mildly worked but I feel it all starting up again. Plus antibiotics often make you have diarrhea more anyways. So I wasn't sure about it all. I never had luck with rifaximin and its not approved here in US for the dose or length of time you need it to. Something like 14 days. So I only tried it once a few years ago when my doctor amazingly had enough samples to give me. The days of samples are gone it seems.

But no..I never had any negative experience with Pepto BIsmal or Kaoepectate which is the same thing.
 

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Discussion Starter · #3 ·
Thanks for your input. Ive tried a bunch of antibiotics but never cipro...was always worried about the achilles tendon warnings.

Just fyi if you want to try rifaximin you can easily order it online. I would search for it as rifaxiheal. It takes a month or so to arrive. You can buy what you need and it is fairly inexpensive compared to the rates here too. Although its still one of the pricier antibiotics compared to the old generic antibiotics like amoxicillin.
 

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Discussion Starter · #4 ·
Just out of curiosity has anyone tried the protocol that some people have been treated for microscopic colitis? It is 2 tablets of 262mg pepto bismol taken 4 times per day. For a total of 8 tablets per day and taken every day for 8 weeks.
 

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I've heard of it. This is probably the study you're referring to. Sounds safe. I might give it a try next as just my swig of pepto before meals wasn't really doing much.

And FYI...I decided to start this today. I have a box of chewable Pepto Bismals. I just ordered 4 more boxes. So I'm game to take 8 a day for 8 weeks. See what happens.

https://www.gastrojournal.org/article/S0016-5085(98)70629-8/fulltext
 

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Discussion Starter · #6 ·
Sounds good. I wish you excellent results and will be looking forward to seeing your updates. I think I will try it in a couple weeks if what I am trying right now proves to be a failure.
 

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Well one day in and I will tell you, its not easy eating 8 of these a day. They really make you sick to your stomach and I feel like constipation is coming on and my stomach is kind of in knots. I'll keep ya posted.
 

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Upate. I stopped this Pepto Bismal routine. 8 tabs a day is just too much. I was getting sick to my stomach. Bloated. Constipated with the urgency to still go.

I contacted my gastro doc about it and he said you could try it but I personally dont have microscopic colitis which I think its aimed at. So I stopped it last night and I already feel better.

Good luck if you guys try it!
 

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Hey Mello, really sorry to hear you're still struggling with your IBS. I know the feeling...!

I really like Pepto, and am somewhat of a Pepto addict, being that it is one of the only supplements that provides relief for my IBS. Hopefully my experiences can provide some help for anyone using it too.

Firstly, it is safe to take at fairly high dosages for long term, however if you start getting ringing in your ears then it's time to lower your dose (tinnitus can be caused by both bismuth and salicylate toxicity).

Secondly, it's important to know that 525mg of Bismuth Subsalicylate (which is the amount in 2 pills, 30ml of regular strength liquid, or 15ml of the max version) is equivalent to one adult aspirin. The bismuth gets converted in the stomach to bismuth oxychloride and salicylic acid. So this provides quite a nice anti-inflammatory effect! If I ever need to go out for a long day, on an empty stomach I take 1500mg of bismuth, and it really "cools" my system. However it's worth knowing this because salicylates can interact with things and also cause blood thinning, so be careful if you have any issues that could be exacerbated by the Pepto.

Ok on to my tips:

-My favorite way of taking it is Kaopectate Max. It has the best ingredient profile of any Bismuth product in my opinion.

  • With the Max concentration, you only have to drink half the amount to get the same dose as the regular, so any side effects from the weird gums and flavorings will be cut down.
  • Pepto Liquid contains sucralose, which is known to have negative effects on the gut microbiome. This is a huge no-no for me considering how much of it I drink. The Kao contains sucrose, just regular ol' sugar (albeit a very small amount).
  • Pepto Liquid pills contain sorbitol and the chewable pills contain mannitol! Sugar alcohol cause gas and bloating even in normal people. For me, the pepto pills give me terrible gas, I hate them. I believe it's the sorbitol/mannitol, so I stay away. They cause me more issues than they solve.

-I always take it on an empty stomach if I can.

  • I have found when taking it on an empty stomach, it works much faster and with far fewer side effects. If I take it on a full stomach, I sometimes get weird excessive burping, and it occasionally just doesn't work at all. Of course with food in the stomach, the pepto won't reach the colon for many hours. On a truly empty stomach it could reach the colon in only a few hours, and if you're having really bad diarrhea it can get to the colon very fast!
  • So my favorite times to take it are at least 3 hours after the last meal, and 1 hour before the next meal. I like to take it when I wake up in the morning an hour before breakfast with a huge glass of water. I can usually have an "ok" day if I do this. Then I like to take it again an hour before dinner. Those are my two doses. Of course sometimes I take it before bed, before lunch, etc... if it's needed, it's needed!

So far, I have not figured out how to use bismuth to help "cure" me (for example combining it with pre/probiotics, various diets, etc). I also have an underlying belief that it could be preventing me from healing due to it's anti-bacterial effects. It'd be like taking an anti-biotic long term, which might not be helpful when trying to establish a better microbiome! But the effects of it are numerous so it's hard to know what is helping me:

"The mechanism of action of bismuth subsalicylate in these gastrointestinal disorders is not completely understood. Although colloidal bismuth compounds have no significant acid-neutralizing capacity, they inhibit the action of pepsin, increase the secretion of mucus, and interact with protein in necrotic ulcer craters, presumably forming a barrier to the diffusion of acid. Bismuth colloids have an antibacterial action, which is relevant for the treatment of infectious diarrhea and peptic ulcers (e.g., Helicobacter pylori). The salicylate component of bismuth subsalicylate may exert intestinal antiinflammatory and antisecretory actions. Thus, the combined antibacterial and intestinal antisecretory action of bismuth subsalicylate is relevant for the OTC treatment of mild to moderate diarrhea. Pepto-Bismol controls diarrhea within 24 hours, and also relieves associated abdominal cramps."

Anyways, I am currently taking it twice daily now but frequently take month-long or more breaks. I think I prefer to use it as a "spot" treatment when I have to go do something for the day, and drink a lot of it on an empty stomach prior to going out.

Lastly this link is a great jumping off point for learning about Bismuth: https://www.sciencedirect.com/topics/pharmacology-toxicology-and-pharmaceutical-science/bismuth-subsalicylate

Take care all, best of luck and let me know what works/doesn't work for you!
 

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Upate. I stopped this Pepto Bismal routine. 8 tabs a day is just too much. I was getting sick to my stomach. Bloated. Constipated with the urgency to still go.

I contacted my gastro doc about it and he said you could try it but I personally dont have microscopic colitis which I think its aimed at. So I stopped it last night and I already feel better.

Good luck if you guys try it!
sad to hear it didn't work. but thank you for sharing your experience with it
 

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Discussion Starter · #12 ·
Hey Mello, really sorry to hear you're still struggling with your IBS. I know the feeling...!

I really like Pepto, and am somewhat of a Pepto addict, being that it is one of the only supplements that provides relief for my IBS. Hopefully my experiences can provide some help for anyone using it too.

Firstly, it is safe to take at fairly high dosages for long term, however if you start getting ringing in your ears then it's time to lower your dose (tinnitus can be caused by both bismuth and salicylate toxicity).

Secondly, it's important to know that 525mg of Bismuth Subsalicylate (which is the amount in 2 pills, 30ml of regular strength liquid, or 15ml of the max version) is equivalent to one adult aspirin. The bismuth gets converted in the stomach to bismuth oxychloride and salicylic acid. So this provides quite a nice anti-inflammatory effect! If I ever need to go out for a long day, on an empty stomach I take 1500mg of bismuth, and it really "cools" my system. However it's worth knowing this because salicylates can interact with things and also cause blood thinning, so be careful if you have any issues that could be exacerbated by the Pepto.

Ok on to my tips:

-My favorite way of taking it is Kaopectate Max. It has the best ingredient profile of any Bismuth product in my opinion.

  • With the Max concentration, you only have to drink half the amount to get the same dose as the regular, so any side effects from the weird gums and flavorings will be cut down.
  • Pepto Liquid contains sucralose, which is known to have negative effects on the gut microbiome. This is a huge no-no for me considering how much of it I drink. The Kao contains sucrose, just regular ol' sugar (albeit a very small amount).
  • Pepto Liquid pills contain sorbitol and the chewable pills contain mannitol! Sugar alcohol cause gas and bloating even in normal people. For me, the pepto pills give me terrible gas, I hate them. I believe it's the sorbitol/mannitol, so I stay away. They cause me more issues than they solve.
-I always take it on an empty stomach if I can.
  • I have found when taking it on an empty stomach, it works much faster and with far fewer side effects. If I take it on a full stomach, I sometimes get weird excessive burping, and it occasionally just doesn't work at all. Of course with food in the stomach, the pepto won't reach the colon for many hours. On a truly empty stomach it could reach the colon in only a few hours, and if you're having really bad diarrhea it can get to the colon very fast!
  • So my favorite times to take it are at least 3 hours after the last meal, and 1 hour before the next meal. I like to take it when I wake up in the morning an hour before breakfast with a huge glass of water. I can usually have an "ok" day if I do this. Then I like to take it again an hour before dinner. Those are my two doses. Of course sometimes I take it before bed, before lunch, etc... if it's needed, it's needed!
So far, I have not figured out how to use bismuth to help "cure" me (for example combining it with pre/probiotics, various diets, etc). I also have an underlying belief that it could be preventing me from healing due to it's anti-bacterial effects. It'd be like taking an anti-biotic long term, which might not be helpful when trying to establish a better microbiome! But the effects of it are numerous so it's hard to know what is helping me:

"The mechanism of action of bismuth subsalicylate in these gastrointestinal disorders is not completely understood. Although colloidal bismuth compounds have no significant acid-neutralizing capacity, they inhibit the action of pepsin, increase the secretion of mucus, and interact with protein in necrotic ulcer craters, presumably forming a barrier to the diffusion of acid. Bismuth colloids have an antibacterial action, which is relevant for the treatment of infectious diarrhea and peptic ulcers (e.g., Helicobacter pylori). The salicylate component of bismuth subsalicylate may exert intestinal antiinflammatory and antisecretory actions. Thus, the combined antibacterial and intestinal antisecretory action of bismuth subsalicylate is relevant for the OTC treatment of mild to moderate diarrhea. Pepto-Bismol controls diarrhea within 24 hours, and also relieves associated abdominal cramps."

Anyways, I am currently taking it twice daily now but frequently take month-long or more breaks. I think I prefer to use it as a "spot" treatment when I have to go do something for the day, and drink a lot of it on an empty stomach prior to going out.
Lastly this link is a great jumping off point for learning about Bismuth: https://www.sciencedirect.com/topics/pharmacology-toxicology-and-pharmaceutical-science/bismuth-subsalicylate

Take care all, best of luck and let me know what works/doesn't work for you!
Thanks for the info! I appreciate hearing your experience! IBS is such a daily grind. One of these days we will find something.
 

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Based on your information I started using Kaopectate. The Max wasn't in my local pharmacy so I got the regular but after two uses, I really like it. I generally use immodium but so far this has proven more effective. I ordered 5 Max Peppermint although I don't hate the vanilla in the regular (maybe max is stronger flavor). I have been taking a probiotic (Spogest) which has worsened my situation but even with that the Kaopectate has been effective. Thanks for the good info.
 

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Based on your information I started using Kaopectate. The Max wasn't in my local pharmacy so I got the regular but after two uses, I really like it. I generally use immodium but so far this has proven more effective. I ordered 5 Max Peppermint although I don't hate the vanilla in the regular (maybe max is stronger flavor). I have been taking a probiotic (Spogest) which has worsened my situation but even with that the Kaopectate has been effective. Thanks for the good info.
Cool to hear that it's helping you so far! I prefer it to Imodium as well, though I generally keep Imodium on hand in case of emergencies. I try to rarely take it these days, maybe once a year, because I find it messes me up for a few days. But the Bismuth/Imodium combo can really halt a bad attack for me. Let us know how the Max peppermint works out!
 
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