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Can Pepto-Bismol Work Long-Term?

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Q. I have diarrhea regularly. I have read your column with some great suggestions for more natural remedies.

What I have the most success with is Pepto-Bismol. Are there any ingredients in it that would make it harmful to take one or two tablets three or four times a week?

A. Pepto-Bismol has a long history dating back to the early 20th century. It was originally developed to treat severe diarrhea in babies.

The active ingredient is bismuth subsalicylate. It remedies a wide range of digestive problems including heartburn, diarrhea and nausea. Since the label says you can safely take up to 16 tablets in 24 hours, your dose is not unreasonable.

Despite its good safety record, Pepto-Bismol is not meant to treat a chronic condition. Too much bismuth can lead to loss of appetite, canker sores and poor absorption of nutrients. The salicylate component can cause ringing in the ears. You should check with your doctor about the cause of the diarrhea to see if that can be addressed.
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I can't speak of the effectiveness of taking Pepto Bismol regularly since most of my experiences with it have been with giving it to my dogs (and it works very well)...but I do want to comment on regular diarrhea, which can occur from many causes.
I used to get diarrhea frequently when I ate out and would wind up accusing the restaurant food of giving me food poisoning.

Eventually I began to see a link between the spasms and urgency with the fat content in food. I began taking digestive enzymes, which greatly helped. I tried several brands and one worked the best. It also helps, of course, not to eat food with a lot of fat content!

I've been told that fat intolerance is linked to gall bladder problems. I've never had an attack, but if the condition is genetic I may have inherited it from my mother, who had had horrible pain from her gall bladder and eventually had it removed.

I, too, suffered greatly from IBS with major diarrhea problems. I tried everything (including Pepto-Bismol). This is the only thing that has worked for me:
Acacia Tummy Fiber that is available at
It has changed my life.

A newer Kaopectate with a blue cap cover and label contains the same amount of bismuth subsalicylate as Pepto Bismol without the red dye ingredient.


I know that a daily dose of Pepto Bismol is recommended when traveling to certain countries, but I can't recall the correct dosage. Please help!


I would like to know if there is a prescription that I can get that contains the same ingredients or similar as Pepto Bismol. I have colitis and that seems to be the only thing that helps. Thanks

When my wife (Japanese) was first given Pepto Bismol here in the states, it knocked her out like a light. This also happened a second time. This is now on the list of medications to which she is allergic. We wish we knew what was in it that was causing the problem.

I have ulcerative colitis, and at times have urgency to find a bathroom.

I've recently discovered that one regular dose of liquid Pepto-Bismol at night, before bed, helps to regulate me and removes the urgency to find a bathroom during the day.

I use it to treat my IBS. It's the only thing that works, but I take it at bedtime every night. is that to much? I have tried everything for IBS but nothing works. I'm not as bloated it regulates me also.

Are you on any other meds such as Asacol? Did the pepto cause any side effects?

I was just diagnosed with IBS and had terrible diarrhea sometimes six times per day. It seemed that any food or drink, even water that I put in my mouth sent me running to the bathroom. I am a young, attractive, and active woman and this was keeping me from enjoying life and being focused at work.

For a few years, I took Immodium, but ONLY on days when I knew I'd be away from a bathroom for long periods of time, which was only about twice per month. Every other day, I suffered with chronic diarrhea. I stopped going out and limited my activities to indoor ones. When I'd take the Immodium, it would cause terrible constipation and I could only take it every once in a while because it made my bowels and stomach feel strange. I would even get headaches from it.

My doctor recommended Pepto Bismol and said I can take it every day. It has been like a miracle. I can now eat the foods I like. My diet mostly consists of healthy foods and high fiber; previously, I had to quit fruits and veggies because the fiber would cause horrible diarrhea. I am still going to monitor myself on the Pepto Bismol and try Keopectate but so far so good!

For those who say they have chronic diarrhea don't just write it off as IBS. I went for a full year of having the runs, which I attributed to IBS. They did a biopsy on my colon when I had a colonoscopy even though nothing looked suspicious. It turns out I have collengous microscopic colitis. The gastro dr. started me on heavy doses of pepto to see if it would correct itself which it didn't so the next step is to go on a heavier drug.

It can be corrected. I will have flare ups from time to time I'm told, but that could be yearly, every 5 years or 10 years, no one knows. My gastro dr. having looked at the colon felt I was crazy with my complaint, but took the step further to biopsy. So glad he did!

My colonoscopy revealed nothing wrong in either upper or lower tract and tissue samples were also all negative. Dr said to just keep taking Pepto Bismol several times a day and night. That helps. But I worry not only about overdose but if the salicilate makes my blood too thin and might interfere with my Coumadin therapy which is to prevent blood clots. Anyone know?

I have been taking Pepto Bismol regularly for about 2 years. I started with 2 pills three times a day and sometimes now use less. If I have a "flare" up I drink the liquid. I have IBS and also an inflamed duodenum. Of all the things I've ever taken Pepto Bismol works best although I do take probiotics and watch my diet.

Occasionally I will take Imodium (2 -3 pills a week) when I flare up along with the Pepto. It's not a cure, but certainly does help regulate. My concern is that it will eventually not work as well and I'd like to hear comments from any other long term user regarding this. Also are there any negative side effects? I've had elevated (mild) kidney function numbers as well as ringing in my ears and not sure they are related to the Pepto Bismol or not.

The ringing in your ears is often associated with long term use. You should cut back or not take any and see if it stops. You may bet more relief by adopting a glutinous free diet or even going a step further and trying a paleo diet. These diets have shown to help with IBS as well as other gastro diseases. Good luck.

KJK, Microscopic colitis can be caused by some antidepressants and sometimes NAIDS like aspirin. My friend got a perforated intestine and is lucky to be alive after taking a steroid for microscopic colitis. He told his doctor that his problems started soon after taking an antidepressant and the doctor didn't believe him. The Dr. put him on a steroid to mask the symptoms. Then he ended up in hospital with the perforated intestine, changed doctors, changed antidepressants and no longer has microscopic colitis.

As for me, I have IBS, no known cause yet, but my doctor said it is unhealthy to take pepto everyday, even if only taking one pill a day and that I need to go on some kind of intestinal nerve relaxer. I won't right now. I'm looking for the cause. I'm not interested in masking a symptom. I think I may have parasites. I've had stool tests, but only one and supposedly it can take up to 4 to find anything. Just an fyi.

I also have collaginous colitis confirmed by biopsy and am in 3rd recurrence. I was taking up to 12 Imodium daily doc approved. I got a terrible purplish sunburn. I have switched temp to pepto bismol. I wondered if anyone has experience with photo sensitivity with pb?

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