Digestive Health Irritable Bowel Syndrome Treatment How Safe Is Using Pepto-Bismo? Review the Side Effects You Should Know About By Barbara Bolen, PhD Barbara Bolen, PhD Twitter Barbara Bolen, PhD, is a licensed clinical psychologist and health coach. She has written multiple books focused on living with irritable bowel syndrome. Learn about our editorial process Updated on August 26, 2021 Medically reviewed Verywell Health articles are reviewed by board-certified physicians and healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Priyanka Chugh, MD Medically reviewed by Priyanka Chugh, MD LinkedIn Priyanka Chugh, MD, is board-certified gastroenterologist with a background in internal medicine. She practices with Trinity Health of New England in Waterbury, Connecticut. Learn about our Medical Review Board Print Table of Contents View All Table of Contents Uses Before Taking How to Take Side Effects Many people turn to Pepto Bismol (or Kaopectate) when they have an upset stomach or diarrhea. These problems may occur more frequently if you have irritable bowel syndrome (IBS) and you might use Pepto Bismol to alleviate IBS symptoms. It is good to learn about its safety and potential side effects. Verywell / Brianna Gilmartin Uses Pepto Bismol is primarily used for the short-term treatment of the following digestive symptoms in adults and children aged 12 and older: DiarrheaNauseaStomach upsetIndigestionHeartburnExcessive intestinal gasExcessive burpingA feeling of fullness caused by eating too muchDiscomfort from drinking too much alcohol Interestingly, researchers have found that when Pepto Bismol is combined with antibiotics it can be quite effective in treating Helicobacter pylori, an infection that has been linked to peptic ulcers and gastritis. How Pepto Bismol Works The scientific name for the active ingredient in Pepto Bismol is bismuth subsalicylate. Bismuth is a mineral that has antibacterial, antacid, and antidiarrheal effects. Subsalicylate is a medication from the same class as aspirin. The active ingredients of Pepto Bismol are thought to have the following actions within the body: Increasing the amount of fluid that is absorbed in the intestines, therefore firming up stoolReducing inflammationCalming intestinal spasmsReducing the population of disease-causing bacteria and/or virusesReducing excess levels of stomach acid Before Taking Pepto Bismol is only recommended for use for a two-day period. That, therefore, makes it a poor choice as a treatment for people who experience chronic diarrhea, common in those with IBS. It also makes it a poor choice for people who experience chronic heartburn or acid reflux from gastroesophageal reflux disease (GERD). Before taking Pepto Bismol it is essential that you clear it with your healthcare provider, as the medication may interact with other medications that you are taking, particularly some medications for diabetes or gout, blood thinners, and certain antibiotics. Precautions and Contraindications Pepto Bismol should not be taken by anyone who: Is younger than 12 years of age Has the flu Has a fever and signs of blood in the stool Has chickenpox or has received the chickenpox vaccination within the past six weeks Is pregnant Is breastfeeding Is allergic to aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) How to Take Pepto Bismol Pepto Bismol is an oral medication that comes in liquid, tablet, or chewable form. Follow the directions and dosing recommendations on the product packaging carefully. You do not need to take the medication with food. Do not take Pepto Bismol for more than two days. Be sure to drink plenty of water while taking Pepto Bismol to replace fluid lost from diarrhea episodes. Side Effects Pepto Bismol is considered to be quite safe for short-term use by adults and children who are age 12 or over. When used properly, the only side effect may be a temporary and harmless blackening of the tongue or of the stool. In some cases, the medication may work too well, with constipation as a result. Serious side effects of Pepto Bismol are rare, but not unheard of. For the elderly, any resulting constipation may lead to a bowel blockage. For children and teenagers, as Pepto Bismol is in the aspirin family, the biggest risk associated with the medicine is the development of Reye's syndrome, a potentially life-threatening illness. This risk is particularly high for those who have chickenpox, influenza (the flu), or any other type of viral infection. However, there is a product for children called Pepto Kids. It does not contain bismuth subsalicylate and thus does not carry the same risk as Pepto Bismol. Pepto Kids is designed to treat heartburn and upset stomach in children. When to Call a Healthcare Provider You should contact your healthcare provider immediately and stop taking Pepto Bismol if you experience:Ringing in the earsDiarrhea that lasts for more than two daysSevere vomitingHigh feverAny signs of an allergic reactionIf you think you have taken an overdose or are experiencing any severe symptoms, seek immediate attention by calling an ambulance. A Word From Verywell Although it may be tempting to take Pepto Bismol to address IBS symptoms, remember that it is only recommended for a maximum of two days. Thus, it is best only for short-term symptoms, and long-term use may enhance side effects. When you're experiencing chronic symptoms, work with your healthcare provider to find a better solution. Frequently Asked Questions What are the side effects of Pepto-Bismol? The most common side effect of Pepto-Bismol is a black tongue or black stools. Both are harmless. Pepto-Bismol contains a non-toxic metal called bismuth that, when mixed with sulfur (a naturally occurring mineral in the body), forms a black substance called bismuth sulfide. Can Pepto-Bismol cause severe side effects? On rare occasions, Pepto-Bismol has been known to cause potentially serious side effects. Call your healthcare provider if you experience any of the following after taking Pepto-Bismol:Severe vomitingBlood in stool (usually mild)Coffee ground-like vomit (a sign of gastric bleeding)Tinnitus (ringing or buzzing in the ears) Learn More: When to See a Healthcare Provider About Vomiting Who should not take Pepto-Bismol? Pepto-Bismol is contraindicated for use in people with the following conditions:Aspirin allergyGastric ulcerHematochezia (bloody stools)HemophiliaFlu-like symptoms (for children and teens only due to the risk of Reye's syndrome)Also, children under age 12 should not take regular Pepto-Bismol; children under 2 shouldn't take Pepto-Bismol Kids. Is Pepto-Bismol safe during pregnancy? Pepto-Bismol contains bismuth subsalicylate, a drug that is generally avoided during the third trimester as it increases the risk of uterine bleeding. There remains considerable debate as to the actual risk, but it may be best to avoid Pepto-Bismol just to be safe. What drugs interact Pepto-Bismol? Pepto-Bismol can potentially interact with a wide range of medications. Let your healthcare provider know if you take any of the following before starting Pepto-Bismol:Arthritis or gout medicationsBlood thinners like warfarinDaily aspirinDiabetes medicationsTetracycline antibiotics What are the alternatives to Pepto-Bismol? There are several over-the-counter alternatives to Pepto-Bismol based on the symptom being treated:Heartburn can be relieved with antacids, H2 blockers, or proton pump inhibitors (PPIs).Indigestion can be relieved with Alka-Seltzer (sodium bicarbonate) or Mylanta (simethicone)Constipation can be treated with stool softeners and osmotic, stimulant, or bulk-forming laxativesDiarrhea can be treated with Imodium (loperamide)Nausea may be treated with Dramamine (dimenhydrinate) or Bonine (meclizine). Learn More: Natural Remedies to Soothe Indigestion Was this page helpful? Thanks for your feedback! One of the most challenging aspects of having IBS is trying to figure out what's safe to eat. Our recipe guide makes it easier. Sign up and get yours now! Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit 6 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. U.S. National Library of Medicine. Label: Pepto Bismol—bismuth subsalicylate kit. Graham DY, Lee SY. How to effectively use bismuth quadruple therapy: The good, the bad, and the ugly. Gastroenterol Clin North Am. 2015;44(3):537-63. doi:10.1016/j.gtc.2015.05.003 Procter & Gamble. Pepto Bismol Original Liquid [package labeling]. Budisak P, Abbas M. Bismuth subsalicylate. In: StatPearls [Internet]. Servery J, Chang J. Over-the-counter medications in pregnancy. Am Fam Physician. 2014 Oct 15;90(8):548-55. MedlinePlus. Bismuth subsalicylate.