Incontinence (Bowel)
Charles Theisler in Adjuvant Medical Care, 2023
Anti-diarrheal drugs such as kaolin, pectin, activated charcoal, loperamide hydrochloride (Imodium A-D), diphenoxylate, and atropine sulfate (Lomotil), as well as aluminum hydroxide, are often utilized to increase the viscosity of the stool. Bismuth agents (Pepto-Bismol) are also used for acute episodes of diarrhea due to their antisecretory, anti-inflammatory, and antibacterial effects.1Bulk-forming agents such as psyllium (Metamucil), polycarbophil (FiberCon), and carboxmethycellulose (Citrucel) absorb water and increase stool bulk.1Phenylephrine Cream: Preliminary studies evaluating the effect of phenylephrine on the anal sphincter demonstrated increased resting sphincter pressure with topical application of phenylephrine cream.1 Overall, patients reported improvement when receiving the active drug rather than a placebo, and more cases receiving phenylephrine gel achieved full continence or improved their incontinence symptoms.2
“New York Is Where I'd Rather Stay”
James Melson in The Golden Boy, 2013
The waiter brought a bottle of wine that looked like it predated the French Revolution, uncorked it and offered it to Spencer to taste. He went through the whole routine and nodded approval. My own experience with wine consisted of communions at Holy Trinity Lutheran Church in Dubuque, and that only on my parents' insistence. Given the option, I would rather have drunk Pepto Bismol. The wine Spencer had chosen was definitely not for the neophyte. With rather less gusto than Socrates downing his hemlock (a Chateau Thebes 486 B.C., I believe), I forced myself to drink. I too had a point to prove: I wanted to show Spencer that my taste in drink was a bit more sophisticated than beer blasts in Iowa farm fields.
Black tongue Pepto-Bismol
Alisa McQueen, S. Margaret Paik in Pediatric Emergency Medicine: Illustrated Clinical Cases, 2018
The mother has been giving the patient Pepto-Bismol (bismuth subsalicylate) intermittently for his stomach discomfort, which is the likely cause of this patient's tongue discoloration. Patients may also report darkening of the stools. According to the product website, “when a small amount of bismuth combines with trace amounts of sulfur in your saliva and gastrointestinal tract, a black-colored substance (bismuth sulfide) is formed.” This is a temporary and benign side effect of Pepto-Bismol. Symptoms should resolve several days after stopping the medication. No workup is required unless an alternate cause is suspected.
The protective role of autophagy in nephrotoxicity induced by bismuth nanoparticles through AMPK/mTOR pathway
Published in Nanotoxicology, 2018
Yongming Liu, Huan Yu, Xihui Zhang, Yong Wang, Zhentao Song, Jian Zhao, Haibin Shi, Ruibin Li, Yangyun Wang, Leshuai W. Zhang
However, the potential applications of bismuth nanomaterials suggest the exposure and risk of bismuth on human and environmental health. Other than bismuth nanomaterials, bismuth salts such as colloidal bismuth subcitrate (CBS) and bismuth subsalicylate have been commonly used to treat peptic ulcers (Andrews etal. 2006; Marcus, Sachs, and Scott 2015). In addition, bismuth compounds such as bismuth vanadate, bismuth nitrate, and bismuth oxychloride have been applied as the raw materials for foundation in cosmetics. However, overdose of bismuth compounds can cause acute renal failure that has been mentioned by a numerous of clinical cases (Işlek etal. 2001). For example, during the treatment of Helicobacter pylori infections, CBS overdose has been reported to result in severe nephrotoxicity, such as necrosis in the proximal tubules (Leussink etal. 2001). In addition, bismuth oxybromide (BiOBr) NPs have been utilized in semiconductor industry, but BiOBr was found to be toxic to human skin keratinocytes (Gao etal. 2015). In spite of plenty case reports on bismuth nephrotoxicity, there were very limited studies to elucidate the mechanisms of bismuth nephrotoxicity in the cellular and molecular level.
Factors associated with treatment failure, and possible applications of probiotic bacteria in the arsenal against Helicobacter pylori
Published in Expert Review of Anti-infective Therapy, 2023
Amir Hossein Miri, Mojtaba Kamankesh, Mazda Rad-Malekshahi, Abbas Yadegar, Maryam Banar, Michael R. Hamblin, Ismaeil Haririan, Hamid Asadzadeh Aghdaei, Mohammad Reza Zali
BQT consists of a standard dose of a PPI twice a day, metronidazole (500 mg) three times daily, bismuth subsalicylate (525 mg), and tetracycline (250–500 mg) all given four times daily over 14 days [43]. Moreover, BQT could be modified by substitution of amoxicillin for tetracycline. In this regard, a meta-analysis study by Bang et al. [44] confirmed that successful H. pylori eradication could be achieved by using either BQT or modified BQT (20 mg rabeprazole+1 g amoxicillin+500 mg metronidazole+300 mg bismuth subcitrate) regimens in regions with a high level of clarithromycin and metronidazole resistance. The eradication rates were as follows: modified BQT: 87.2% vs BQT: 82.2%, intention-to-treat (ITT) analysis; modified BQT: 96.2% vs BQT: 96%, modified ITT analysis; (modified BQT: 96.2% vs BQT: 96.9%, per-protocol (PP) analysis). This suggests that the modified-BQT regimen shows good potential to control H. pylori infection.
Delayed diagnosis of a case of Zenker’s diverticulum. What may happen when a family physician does not visit his family physician
Published in European Journal of General Practice, 2018
Zekeriya Akturk, Ali Bilal Ulas, Atila Eroglu
The patient was diagnosed as having gastroesophageal reflux disease (GERD) and prescribed a scheme of amoxicillin + clarithromycin + pantoprazole + bismuth subsalicylate. After a few days, he returned to his doctor complaining of medication side effects such as burning in his throat and oesophagus and not being able to swallow the pills. However, being warned of the consequences of non-compliance with the treatment, he kept using the medications as advised. There was no improvement in the initial symptoms at the end of the 14-days treatment. The patient was instructed to continue using pantoprazole 40 mg/day for another three months. However, he discontinued the medication after few weeks due to no apparent benefit.
