Updated: 2/22/2018

Bismuth and Sucralfate

Review Topic
  • Mechanism 
    • provides physical protection to ulcer base
      • requires low pH to activate into a paste consistency that adheres to the mucosal wall
      • action may be inhibited by antacids
  • Clinical use
    • ↑ ulcer healing
    • ↓ ulcer recurrence
Bismuth subsalicylate
  • Mechanism
    • similar to sucralfate
  • Clinical use
    • ↑ ulcer healing
    • traveler's diarrhea
    • quadruple therapy of H. pylori ulcers (BMT regimen)
      • Bismuth
      • Metronidazole
      • Tetracycline (amoxicillin)
      • PPI
  • Toxicity
    • harmless black coloring of stool

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