The Medicinal Uses of Pepto-Bismol (Ulcer Patients, Take Note)

Everybody knows about Pepto-Bismol, right?  Any hint of tummy troubles to Mom got you a quick trip to the medicine cabinet for a dose of the pink stuff.  We all “know” so much about it that I’ve only covered it in passing on the blog.  Only two of my off-grid medical texts mention it.

Before moving on to the possibly click-bait reason in the title that got you to open this article, let’s review the common uses for Pepto-Bismol and the different formulations.

Bismuth subsalicylate, the primary active ingredient in Pepto-Bismol, an antacid indicated mainly for complaints we had as children—upset stomach, nausea, and diarrhea—reduces inflammation in the digestive tract.  For the last century that it’s been on the market, adults have taken it for indigestion, heartburn, and traveler’s diarrhea.[1] [2]  Dosage indications for those common complaints are provided on the bottle and won’t be duplicated here.  For traveler’s diarrhea, doctors recommend 1 fluid ounce or two 262-mg tablets,[3] every 30 minutes for up to eight doses per day, for 1-2 days, as needed.[4] 

There are four different Pepto-Bismol formulations to be aware of:

• Liquid
• Liquid capsules
• Tablets
• Chewables

Note that the chewables do not contain bismuth subsalicylate, but rather calcium carbonate.  They’re basically Tums with a more expensive price tag.  For purposes of this article, the chewables should be ignored.

Dr. Alton in his Survival Medicine Handbook, 4^th Edition, notes that Pepto-Bismol may provide symptomatic relief for typhus and typhoid patients.[5]

Now for the real reason you clicked on this article:

Earlier this summer I was combining business and pleasure, visiting a new grandbaby and his parents in the hospital and staying with the new uncle and aunt at their apartment nearby.  And in the middle of the night, I awoke with stomach pain.  Based on the descriptions of my similarly afflicted children, I was pretty sure it was an ulcer.  Far from home, I didn’t have any herbs to start treating it, and I was determined to avoid Big Pharma’s solutions. 

I was hoping (but not confident) that drinking a lot of water and making some dietary changes would solve the issue.  Of course, it didn’t in my case.  But at least the pain wasn’t too bad the following day. 

Upon arriving home, I began taking a combination of chamomile, calendula, and purslane and slept perfectly that night.  Success!  Unfortunately, a couple of hours later I doubled over in pain.  Not success!!  It was time to try the remedy Jared started using for his ulcers based on a recommendation from his father-in-law, a medical doctor:  Pepto-Bismol.

???

The label clearly warns against using Pepto-Bismol if you have an ulcer.  So I quizzed Jared further.  And he reiterated what his father-in-law and other medical professionals share:

1.  Pepto-Bismol may turn the stool black.

2.  A bleeding ulcer will turn the stool black.[6] 

3.  A patient with a bleeding ulcer may mistakenly attribute a black stool to Pepto-Bismol instead of blood.  And that could be a life-threatening situation.

4.  Pepto-Bismol exerts some antibiotic effects against H. pylori ulcers.[7] [8] [9](Remember, the Pepto-Bismol tablets are only calcium carbonate and have no efficacy against bacteria.)

5.  Do not take Pepto-Bismol if the ulcer is or may be due to NSAID use.  Pepto-Bismol contains salicylates which may worsen an NSAID-induced ulcer.

Then he shared another little nugget:  a dose of Pepto-Bismol alleviates the pain immediately.  Not in 5 minutes, or 3 minutes, but in less than 10 seconds.[10]  (It worked quicker than that for me.)  And that is something that almost nobody else shares.  Having been in that pain, however, I know how significant that fact is.  The pink stuff will always have a happy home in my cabinet.

Side effects:  A black stool, harmless and usually temporary.

Caution:  Pepto-Bismol may interact with blood-thinners.  It should only be used for a short period to manage occasional symptoms.  See a physician for chronic issues.

Links to related posts:

Ulcers  

Typhus  

Typhoid Fever—It’s in the Water 

---

[1] Cynthia Koelker, Armageddon Medicine, 2011, 559.

[2] Joseph Alton, et al., Survival Medicine Handbook, 2021, 274.

[3] Alton, 284.

[4] Cynthia Koelker, Armageddon Medicine, 2011, 559.

[5] Alton, 286.

[6] Alton, 617.

[7] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3601646/

[8] https://nihrecord.nih.gov/2022/04/15/scientists-reveal-good-bad-and-ugly-h-pylori

[9] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4555994/

[10] https://www.verywellhealth.com/how-are-ulcers-treated-1742020