Pepto dosage?

[Kestrel]

Hello. I'm going to start the Pepto Bismol 8-week trial. I've done a lot of research ~ including on the NIH site ~ and have decided to try this for the time-being. However, I'm confused about dosage because everything I read says "two tablets or equivalent dosage per day." There are many different tablet / liquid strengths; I have the 2x strength tablets and liquid. So, 525 mg per 15ml / 1 Tbsp dose. Any thoughts and/or experience with this? Thank you so much.

[Gabes-Apg]

hi there
I did some searching and reading of older posts to see if could provide a link to information that may assist you/ answer your question
sadly no luck.

for situations like this, i think it is best to consult with the pharmacist / doctor and confirm.

[tommyboywalker]

Hello Kestrel,

I tried the "Pepto" treatment but it didn't work for me. I then switched to Budesonide which did work.

At the bottom of this post is what I copied from the Gastro Journal from Dr. Kenneth Fine, who conducted the Pepto trial. He is also the doctor who founded and is in charge of Enterolab, who have done food sensitivity testing for many of us MCers on this forum, including me. It was a very small trial so keep that in mind. This is the dosage I used. 8 chewable 262 mg tablets per day. 262 mg is the "standard" Pepto Bismol dose and I took 2 of those 262 mg tablets 4 times a day. So if you are taking 525 mg tablets, you could take one tablet 4 times a day. Or equivalent of liquid Pepto. The goal to take 525 mg of Pepto 4 times a day is the way I understood it.

In addition, I found this information in the Microscopic Colitis newsletter of November, 2019. The important information I think here is that if you choose to try the Pepto treatment, it should be done in combination with being gluten free.

Dr. Fine no longer recommends the Pepto treatment as a first line treatment for MC, basically for two reasons:

1. Some patients develop tinnitus or neurological issues from using the treatment.

2. The treatment must be done in conjunction with the GF diet, and although remission takes longer without the Pepto Bismol, most MC patients can achieve remission by using the GF diet alone.

Some gastroenterologists still recommend the Pepto treatment today, but they almost always fail to point out that the treatment must be done in conjunction with the GF diet. Consequently, after the treatment ends, their patients usually relapse.

Experience shows that the Pepto treatment is still useful (when used along with the GF diet) for decreasing the amount of time required to reach remission.
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Methods of Trial: Thirteen patients with microscopic colitis (7 with subepithelial collagen deposition and 6 without) were treated with eight chewable 262-mg bismuth subsalicylate tablets per day for 8 weeks. Patients recorded the frequency of bowel movements daily. Forty-eight–hour stool collections and flexible sigmoidoscopy with 24 biopsies were performed before and after treatment in each patient. Results: Twelve patients completed the trial. Eleven patients had a resolution of diarrhea and a reduction in fecal weight. The average time to respond was 2 weeks. In 9 patients, colitis resolved. When present before treatment, subepithelial collagen thickening disappeared. Those completing the trial experienced no side effects. Posttreatment follow-up for 7-28 months shows that 9 patients remain well having undergone no further treatment, 2 are well but required retreatment, and 1 has continued diarrhea.

[Marcia K]

Hello. I'm a Pepto success story, which was recommended by my GI. He did not recommend any dietary changes (so clueless!). I took 2 tablets/4x day for 8 weeks. I had to cut back to 6/day after a few weeks because I became constipated. I did not have any adverse reaction to the Pepto. I took regular strength tablets. Do not chew the tablets or your tongue will turn black. I made major dietary changes afterwards or I don't believe I would have been in remission. No gluten, dairy, soy, raw fruits & vegetables. Reading Tex's book and reading the forums here was how I found & stayed in remission.It's almost 7 years now.