Gastric mucosal protection via bismuth salt

Bismuth subsalicylate is an inorganic compound used as a non-specific gastrointestinal protective agent. It acts primarily by forming a physical protective barrier over the gastric mucosa, promoting healing and preventing damage from irritants such as acid, alcohol, and infectious organisms. Bismuth also has local antimicrobial activity, inhibiting the adhesion and growth of bacteria including Helicobacter pylori. The salicylate component confers anti-inflammatory properties by inhibiting cyclooxygenase, thus reducing prostaglandin-mediated irritation and inflammation. The pharmacological effect is local; bismuth subsalicylate does not bind or inhibit a specific protein target in the way typical targeted drugs do.

Other names

Pink bismuthPepto-BismolPepti-CalmBisBacter

Coats gastric mucosa, forming a protective barrier; Hydrolyzes to bismuth and salicylic acid in stomach; bismuth minimally absorbed, acts locally; Inhibits bacterial adhesion and enzyme activity (phospholipase, protease, urease); Antimicrobial activity: disrupts bacterial cell wall, membrane, and ATP synthesis; Salicylate inhibits cyclooxygenase (anti-inflammatory), reduces prostaglandin-induced inflammation; Reduces secretion of fluids in response to bacterial toxins (antisecretory); Promotes reabsorption of fluids and electrolytes