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While some complementary and alternative techniques have been studied scientifically, high-quality data regarding safety, effectiveness, and mechanism of action are limited or controversial for most therapies. Whenever possible, it is recommended that practitioners be licensed by a recognized professional organization that adheres to clearly published standards. In addition, before starting a new technique or engaging a practitioner, it is recommended that patients speak with their primary healthcare provider(s). Potential benefits, risks (including financial costs), and alternatives should be carefully considered. The below monograph is designed to provide historical background and an overview of clinically-oriented research, and neither advocates for or against the use of a particular therapy.

Related Terms

  • 214Bi, basic bismuth carbonate (BSC), basic bismuth gallate (BSG), basic bismuth nitrate (BSN), basic bismuth salicylate (BSS), Bi, Bi2O3, biscu, Bismatrol®, Bismatrol® Extra Strength, Bismed®, bismuth aluminate (BA), bismuth ammonium citrate, bismuth biskalcitrate, bismuth carbomer enemas, bismuth gallate, bismuth (III), bismuth oxynitrate, bismuth phosphate, bismuth salts, bismuth subgallate, bismuth subnitrate, bismuth subnitrate suspension (B), bismuth subsalicylate, bismuth sulfate agar (BSA), bismuth tribromophenate (Xeroform®), bismuth-207, bismuth-212, bismuth-213, bismuth-ethylenediamine tetraacetate bisodium (bi-EDTA), bismuthi subcitras colloidal, bismuth-peptide complex (BPC, bicitropeptide), BSS, calcium acexamate-light bismuth nitrate, colloidal bismuth, colloidal bismuth pectin (CBP), colloidal bismuth subcitrate (CBS), De-Nol®, Gastrin®, Gastrocaps®, GR122311X, Kaopectate®, karaya bismuth, micronized bismuth subnitrate, Pepto-Bismol®, Pepto-Bismol® Easy-to-Swallow Caplets, Pepto-Bismol® Maximum Strength, PMS-bismuth subsalicylate, Q-ULCER®, ranitidine bismuth citrate (Pylorid®, RBC, Rb, Tritec®), Rbc, Roter®, tripotassium dicitrato bismuthate (TBS, TDB, Ventrisol®), tripotassium dicitratobismuthate (De-Nol®), ulcedal, ulcerine, vicalin, wikalina, Xeroform®.
  • Note: This monograph focuses on bismuth and bismuth subcarbonate, subgallate, or subnitrate single-arm studies. Bismuth subsalicylate, colloidal bismuth subcitrate, bismuth aluminate, and ranitidine bismuth products are alluded to, but not expanded on.


  • Bismuth (Bi) is a chemical element whose atomic number is 83. Bismuth-containing compounds include cosmetics (bismuth oxychloride) and certain drugs. Bismuth is also used in some medical procedures. Bismuth has been used for approximately a hundred years for stomach and intestinal conditions and was the first drug shown to affect the progression of peptic ulcer disease. The historical use of bismuth has been discussed in various reviews.
  • Although the element bismuth has been used since at least the 18th Century, most bismuth-containing products available on the market now are multi-ingredient products or are used in combination with other drugs. These multi-ingredient products will be only briefly discussed in this monograph.
  • Examples of bismuth products used in medicine include bismuth subnitrate, bismuth subcarbonate, bismuth subsalicylate (e.g., Pepto-Bismol®, Kaopectate®), bismuth subgallate (e.g., Devrom®), colloidal bismuth subcitrate (e.g., De-Nol®), and ranitidine bismuth subcitrate.
  • Some preliminary evidence suggests that bismuth carbomer enemas may reduce pouchitis (inflammation in the pouch) that may occur after colon removal. Bismuth subnitrate has been used for treatment of Helicobacter pylori infection, typically in combination with antibiotics, with limited evidence of benefit. Bismuth subgallate has been studied for controlling odor after an ileostomy (a hole surgically constructed in the abdomen to eliminate waste).


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The below doses are based on scientific research, publications, traditional use, or expert opinion. Many herbs and supplements have not been thoroughly tested, and safety and effectiveness may not be proven. Brands may be made differently, with variable ingredients, even within the same brand. The below doses may not apply to all products. You should read product labels, and discuss doses with a qualified healthcare provider before starting therapy.

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The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.

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Most herbs and supplements have not been thoroughly tested for interactions with other herbs, supplements, drugs, or foods. The interactions listed below are based on reports in scientific publications, laboratory experiments, or traditional use. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy.

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Author Information

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Natural Standard developed the above evidence-based information based on a thorough systematic review of the available scientific articles. For comprehensive information about alternative and complementary therapies on the professional level, go to Selected references are listed below.

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The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.