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Is Bismuth A Safe Medicine For The Treatment Peptic Ulcer Disease?

Date:
December 31, 2008
Source:
World Journal of Gastroenterology
Summary:
Researchers in Canada and Germany performed a systematic review and meta-analysis examining adverse events arising from the use of bismuth compounds in Helicobacter pylori (H. pylori) eradication therapy. They concluded that Bismuth is a safe and well-tolerated to treat of H. pylori. The only adverse event occurring more commonly was dark stools.

Bismuth compounds have been used for centuries in medicine. The discovery of H. pylori in 1983 led to renewed interest in bismuth compounds, because these were found to successfully treat the infection in combination with antibiotics. However, in the 1970s bismuth salts, used at high doses for prolonged periods, were found to lead to neurotoxicity. There has been no summary of evidence for the toxicity of bismuth when used for short periods as part of H. pylori eradication therapy.

A research team led by Professor Paul Moayyedi from McMaster University, Canada performed a systematic review and meta-analysis to assess the safety of bismuth compounds, when used in a 1 or 2-week course of H. pylori eradication therapy. They examined the risk of adverse events in randomized controlled trials using bismuth compounds as part of H. pylori eradication therapy compared to other regimens.

Thirty-five randomized controlled trials containing over 4500 patients were identified comparing bismuth with placebo or no treatment, or bismuth salts in combination with antibiotics as part of eradication therapy with the same dose and duration of antibiotics alone or in combination with acid suppression. There were no differences in the total number of adverse events with bismuth versus comparison regimen. Individual adverse events were also no more frequent with bismuth, with the exception of dark stools. There were no significant differences detected in the number of adverse events leading to withdrawal of therapy with bismuth versus comparison regimen.

Their results indicated that Bismuth compounds, when used as part of H. pylori eradication therapy, are safe and well-tolerated. The only adverse event occurring more frequently with bismuth compounds was dark stools, which is of little clinical significance.

These results are encouraging, because there have been recent concerns expressed that PPI-based triple therapies for H. pylori do not lead to satisfactory eradication rates, and therefore the use of bismuth containing regimens has been recommended as a potential first line therapy in the recent Maastricht guidelines. Furthermore, there are now new bismuth combinations commercially available. For these reasons it is important to be sure of the safety of bismuth compounds.


Story Source:

The above story is based on materials provided by World Journal of Gastroenterology. Note: Materials may be edited for content and length.


Journal Reference:

  1. Ford AC, Malfertheiner P, Giguθre M, Santana J, Khan M, oayyedi P. Adverse events with bismuth salts for Helicobacter pylori eradication: Systematic review and meta-analysis. World Gastroenterol, 14(48): 7361-7370 [link]

Cite This Page:

World Journal of Gastroenterology. "Is Bismuth A Safe Medicine For The Treatment Peptic Ulcer Disease?." ScienceDaily. ScienceDaily, 31 December 2008. <www.sciencedaily.com/releases/2008/12/081231005309.htm>.
World Journal of Gastroenterology. (2008, December 31). Is Bismuth A Safe Medicine For The Treatment Peptic Ulcer Disease?. ScienceDaily. Retrieved August 30, 2014 from www.sciencedaily.com/releases/2008/12/081231005309.htm
World Journal of Gastroenterology. "Is Bismuth A Safe Medicine For The Treatment Peptic Ulcer Disease?." ScienceDaily. www.sciencedaily.com/releases/2008/12/081231005309.htm (accessed August 30, 2014).

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