Pepto (bismuth) struggles

Lucy_B · Post by **Lucy_B** » Sat Oct 17, 2015 9:23 am

Hi, folks! I've been doing the Pepto Bismol (bismuth) regimen for about a week now- 5 to 8 pills a day depending on if I remember to take the final dose. I haven't noticed any difference except increased gurgling and tons of excess gas (way more than normal), including gas that is extremely painful and on two occasions has almost made me throw up. I've also lost a little bit more weight. I'm continuing to use 4 Imodium pills a day, as they are what really seem to be controlling the D. If I skip any Imodium at all, I'm in trouble. So...I guess my question for everyone is-- does it seem like maybe the bismuth is a no go? Or is it the kind of thing that has to build up over several weeks? I definitely haven't seen any improvement after one week. However, I'm willing to stick with it if it's something that tends to help after being used for a longer period of time. A note: I had a bad reaction to Lialda recently (relapsed back to WD) and had to discontinue it. I wonder if those of us who are sensitive to mesalamine are also sensitive to the salicylates in Pepto Bismol? I'd love to hear any advice/experiences!

Post by **tex** » Sat Oct 17, 2015 12:00 pm

Hi Lucy,

The "Pepto treatment" typically brings relief from D by approximately 2 weeks, according to published test trials.

However, the originator of the "Pepto treatment", Dr. Kenneth Fine (who published those test trials 15–20 years ago), no longer recommends it as a first line treatment, for the very reason you have mentioned — some patients cannot tolerate it. These days, Dr. Fine recommends diet changes alone, as the optimum treatment for MC.

Tex

Marcia K · Post by **Marcia K** » Sat Oct 17, 2015 1:01 pm

Hi, Lucy. Tex is correct, I believe it was approximately two weeks until I had relief from the D. It was two years ago so I can't really remember. I took 6/day and didn't take anything else but the Pepto. I did not have gas as you describe. I hope you soon find what works for you.

Zizzle · Post by **Zizzle** » Sun Oct 18, 2015 8:26 am

I'm a good responder to Pepto and it doesn't cause me gas. It relieves gas and removes all odor from my stool. That suggests I have hydrogen-producing bacteria contributing to my MC. But I can't take Imodium. The act to trying to stop things up does cause me painful gas. Maybe it's the combo? Has the Sd turned black and odorless on the Pepto?

Lucy_B · Post by **Lucy_B** » Sun Oct 18, 2015 10:45 am

Thanks, everyone! Zizzle, I wondered the same thing so today have only used the Pepto. I'm gonna give that a few days and see how things go. Question for you and Marcia- did you use the tablets or the chewables? I'm taking the Walgreens brand tablets (non-chewable). I feel like the gas situation was better when I was using the chewables, so maybe there is something in the tablet preparation that doesn't agree with me? The inactive ingredients are: D&C Red 27 Aluminum Lake , D&C Red 30 Aluminum Lake , Calcium Carbonate , Magnesium Stearate , Mannitol , Microcrystalline Cellulose , Povidone , Silica Gel , Sodium Starch Glycolate , Stearic Acid. Was thinking it might be the magnesium or the mannitol, but the chewables contain both those things too, so I'm not sure. Hmmm. Tex, I'm sending my sample off for Enterolab testing on Tuesday, so I should have some insight re: food sensitivities within the next few weeks!

Marcia K · Post by **Marcia K** » Sun Oct 18, 2015 10:57 am

Hi, Lucy. I took the chewables but didn't chew them. I broke them in 1/2 and swallowed with water (chewing will turn your tongue black.) It's funny now, I find small boxes of them in old purses, in my car...I didn't leave home without them!

Lucy_B · Post by **Lucy_B** » Sun Oct 18, 2015 11:52 am

Thanks, Marcia! I think I now remember you saying that. I did the same thing for the same reason. ;) Will probably go back to chewable after I finish this bottle of the tablets.

Post by **tex** » Sun Oct 18, 2015 12:20 pm

Lucy wrote:Tex, I'm sending my sample off for Enterolab testing on Tuesday, so I should have some insight re: food sensitivities within the next few weeks!

It took approximately 1 week for my results to be posted (for tests that I had done about 6 or 7 weeks ago).

Tex

Zizzle · Post by **Zizzle** » Sun Oct 18, 2015 6:33 pm

I've only taken Pepto tablets, often store brand. It's possible the chewables contain much more calcium carbonate, which is a known cause of gas...

Lucy_B · Post by **Lucy_B** » Tue Oct 20, 2015 2:26 pm

Ugh, I went without Imodium today, yesterday, and the day before (only took the Pepto), and it's back to WD.

I just emailed my doc to see what he thinks, but my sense is that the Pepto probably isn't going to be a winner here. In other news, I shipped off my poop this morning so should have Enterolab results back pretty soon!

Anyhoo, now I'm trying to decide which treatment option(s) should be my next step. I'm interested in LDN, for sure (and my doc is open to it), but I've also read that it doesn't often work unless a person has multiple AI issues, and I'm not 100% certain that I do. Other than producing thyroid antibodies and having sort-of widespread inflammation, I haven't been officially diagnosed with anything besides MC. The other option would obviously be budesonide, which my doc has also expressed support for. I'm just concerned about the SE's (and expense), and was thinking I'd resort to that last. Hopefully the Enterolab testing will shed some additional light on potential dietary problems. Though I'm already doing a pretty exclusive diet...not sure what more I can cut out. We shall see. Anyway, thanks for all the feedback! Oh, and Zizzle- you had asked me at one point whether the Pepto turned my stool black and removed odor. It's a little darker (not black) and maybe a tad less malodorous. But it certainly didn't remove all smell. If only, lol! My husband would be much obliged.

Zizzle · Post by **Zizzle** » Tue Oct 20, 2015 2:36 pm

Given your elevated thyroid antibodies, miscarriages, and "widespread inflammation," I suspect LDN would help you. LDN calmed my food reactions and digestion overall, but I still have mild, infrequent watery D, which in my case, I think is caused by e.coli or related bacterial overgrowth/dysbiosis. That's why Pepto causes such obvious results for me. It's a local reaction in my case, which explains how LDN could stop my autoimmune disease, and not stop the WD.

Lucy_B · Post by **Lucy_B** » Wed Oct 21, 2015 8:01 am

That's comforting to hear. :) I'm sorry you're still dealing with occasional D, though! Your bacteria theory makes sense. It's been about 8 months for me now. As long as I take 4 - 6 Imodium pills a day, I can significantly control the wateriness/frequency. But I haven't had anything close to a norman in I can't remember when. If I don't take the Imodium, it's back to WD multiple times a day. I wonder if the fact that I respond to Imodium is a good indicator that I'll respond to LDN, since they both work on opiate receptors? That would be sweet. I would go slow and gradually work my way up. Remind me- did you have any side effects when you were starting? Also, is it a no-no to take Imodium and LDN simultaneously? You said couldn't use Imodium and I wondered if that was why. Thanks!!

Zizzle · Post by **Zizzle** » Wed Oct 21, 2015 12:48 pm

I don't know about taking them simultaneously. Frankly, I could take Immodium, but I choose not to, because stopping things up makes me feel gassy and worse. If my theory is right, and my body wants to rid itself of bacterial toxins, I prefer not to keep it in there longer... I've been taking oregano and thyme oil softgels in the evenings with dinner. The D that follows in the morning looks and smells toxic! (but better every day, so it's doing something...)

I started at 2.25 mg LDN and had mild headache, groginess and brain fog the first 3-4 days. Then the cloud lifted and I felt great - more energy and wildly better mood (happy for no reason). I doubled the dose to 4.5 mg after 10 days, again with 3-4 days of adjustment symptoms, then fine. My rashes started to respond at 3 weeks, and I was in full remission by 12 weeks. I get mild rash exacerbations if I have a significant gluten exposure, and if I'm exposed to viruses (when people around me are sick) plus stress.

Gabes-Apg · Post by **Gabes-Apg** » Wed Oct 21, 2015 12:59 pm

SB BOullardi causes gas in alot of people... which is part of the process of 'clearing toxins'

when you are doing these types of treatments, things tend to get worse before they get better
this doesnt mean it isnt working...

Also - everyone is DIFFERENT!
with any change, treatment, approach, give it some time, a few weeks at least. Dont over think it too much
swapping and changing every week is not the ideal

As zizzle mentions, petpo is used as e-coli treatment, and the fact that the protocol is recommended for 8 weeks, means it takes 8 weeks to work - if you want to see if it is going to work for you, stick with it for the 8 weeks...

Lucy_B · Post by **Lucy_B** » Wed Oct 21, 2015 2:18 pm

Thanks for the feedback!! I have a message in to my doc about my experience with the Pepto and whether he thinks it makes sense to move forward with it, or to add LDN. I did not take the Pepto today and haven't gotten any gas, but it's also probably too early to tell whether it'll happen or not. With regard to probiotics, oddly the S. boulardii seems to be one I can tolerate pretty well (or at least Florastor, which I take at night before bed). The one I was using at lunchtime (which I did not take today) is this stuff: http://www.steelespirit.com/ It's got a prebiotic in it, so that could be part of the problem. Anyway, I totally agree with you, Gabes- it's important not to combine too many treatments and to give everything a fair trial. My main concern with the PB was that it seemed to be making things worse, but it sounds like that's normal at first? It definitely doesn't stop D or weight loss, so I might have to continue taking Imodium at the same time. Oh well, c'est la vie. :) Looking forward to seeing what my Enterolab results say!

Lucy