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Bismuth Preparations for Diarrhea

Ray V. McIntyre, MD
JAMA. 1980;244(13):1435. doi:10.1001/jama.1980.03310130015010.
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To the Editor.—  The article on the "Prevention of Traveler's Diarrhea (Emporiatric Enteritis): Prophylactic Administration of Subsalicylate Bismuth" is a valid observation and should be absorbed by all physicians. However, in my personal experience, the doses of subsalicylate bismuth the authors used are considerably greater than are necessary.Also, this compound is widely available commercially in a tablet that is much more convenient for the tourist to pack. Taking one tablet (PeptoBismol) night and morning has thus far protected my wife and me through several foreign trips of up to two weeks' duration. Numerous (though uncounted) patients for whom I have recommended this schedule also have found it effective, and two tablets per day take little space in the luggage.If this schedule of a twice-daily dosage is combined with a modicum of common sense in selection of food and drink, most tourists will fare well. I expect it would


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