Abstract
Bismuth compounds have been used over two centuries for the treatment of various gastrointestinal disorders due to their local protective, demulcent, and antacid properties. Some of the bismuth salts, particularly subnitrates, subgallates, phosphates, or aluminates, used in large doses (15–20 g/day) were reported to cause intoxication involving the central nervous system (encephalopathy) that occurred in France in the last decade in the form of a toxicological epidemic (Bader 1986). This limited the clinical use of bismuth salts in some countries but more recently the preparation of colloidal bismuth subcitrate (De-Nol) was developed and this offered a new approach in ulcer therapy due to the selective binding of the drug to the ulcer base, the formation of a protection barrier against acid-pepsin attack and its activity against Campylobacter pylori (Lee 1982; Marshall et al. 1985). With the successful clinical application of De-Nol in ulcer therapy (Tytgat et al. 1984) no single report of bismuth intoxication has appeared probably due to the low dosage (below 0.5 g/day) of bismuth used and its application in the colloidal form that reduced its absorption from the gut and excluded potential neurotoxicity. It should be mentioned, however, that no side effects have been reported with bismuth subsalicylate (Pepto Bismol) which has been used for stomach discomfort in noncolloidal form but also at low dosage (up to about 2.0 g/day). In some countries bismuth subnitrate is still prescribed at low dosage by general practitioners in peptic ulcer therapy, also without reports of side effects.
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© 1988 Springer-Verlag Berlin Heidelberg
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Konturek, S.J., Brzozowski, T., Drozdowicz, D., Bielanski, W. (1988). Gastroprotective and Ulcer Healing Properties of Bismuth Salts. In: Menge, H., Gregor, M., Tytgat, G.N.J., Marshall, B.J. (eds) Campylobacter pylori. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-83322-9_37
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DOI: https://doi.org/10.1007/978-3-642-83322-9_37
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-642-83324-3
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