Rare TiogaCruiser Posted December 18, 2017 #1 Share Posted December 18, 2017 Something to discuss with your Healthcare Provider on Medscape today, an update of guidelines by the International Society of Travel Medicine includes the following: Bismuth subsalicylate (BSS) may be considered for any traveler to prevent travelers' diarrhea (strong recommendation, high level of evidence). BSS has been studied using four divided doses of either 2.1 g/day or 4.2 g/day (with meals and at bedtime). A lower divided dose of 1.05 g/day has also been shown to be preventive, although it is unclear whether it is as effective as the higher doses. Full guidelines here:https://getawaysfrom21044.wordpress.com/ Link to comment Share on other sites More sharing options...
Krazy Kruizers Posted December 18, 2017 #2 Share Posted December 18, 2017 Thank you for the information. Link to comment Share on other sites More sharing options...
superoma Posted December 18, 2017 #3 Share Posted December 18, 2017 Sorry, that link took me to rafinmed’s blog, his solo cabin challenge. Was the link incorrect or am I missing something. I read his blog and don’t remember anything mention of BSS. Sent from my iPad using Tapatalk Link to comment Share on other sites More sharing options...
KirkNC Posted December 18, 2017 #4 Share Posted December 18, 2017 Problem is you are not supposed to take it for more then two days: https://reference.medscape.com/drug/kaopectate-pepto-bismol-bismuth-subsalicylate-342037 Link to comment Share on other sites More sharing options...
desertr0se Posted December 18, 2017 #5 Share Posted December 18, 2017 Thank you! Link to comment Share on other sites More sharing options...
ger_77 Posted December 18, 2017 #6 Share Posted December 18, 2017 Not long ago a friend of ours was on assignment in India. Over the several months, his North American co-workers all ended up with "Delhi belly" at one time or another, while he remained symptom free. He attributed it to the fact that every day he chewed 1 Pepto Bismol tablet and swears if he returns, he will do so again. I know this is anecdotal, but if it works, go for it! Smooth Sailing! :) :) :) Link to comment Share on other sites More sharing options...
Sea42 Posted December 18, 2017 #7 Share Posted December 18, 2017 Sorry, that link took me to rafinmed’s blog, his solo cabin challenge. Was the link incorrect or am I missing something. I read his blog and don’t remember anything mention of BSS. Sent from my iPad using Tapatalk Same here Link to comment Share on other sites More sharing options...
Straitlover Posted December 18, 2017 #8 Share Posted December 18, 2017 Problem is you are not supposed to take it for more then two days: https://reference.medscape.com/drug/kaopectate-pepto-bismol-bismuth-subsalicylate-342037 I saw this on the link you posted: Traveler's Diarrhea Prophylaxis 2 tablets (262 mg/tab) q6hr for up to 3 weeks I may consider this on my Alaska cruise as long as I can take the caplets. The liquid and the chewables make me throw up. Link to comment Share on other sites More sharing options...
Rare rafinmd Posted December 18, 2017 #9 Share Posted December 18, 2017 Sorry, that link took me to rafinmed’s blog, his solo cabin challenge. Was the link incorrect or am I missing something. I read his blog and don’t remember anything mention of BSS. Sent from my iPad using Tapatalk I'm as mystified by the link as you are. Roy Link to comment Share on other sites More sharing options...
sail7seas Posted December 18, 2017 #10 Share Posted December 18, 2017 (edited) Not long ago a friend of ours was on assignment in India. Over the several months, his North American co-workers all ended up with "Delhi belly" at one time or another, while he remained symptom free. He attributed it to the fact that every day he chewed 1 Pepto Bismol tablet and swears if he returns, he will do so again. I know this is anecdotal, but if it works, go for it! Smooth Sailing! :) :) :) Seems an easy and safe ( for most of us) good method to try. check with our doc tors and we may all come back blessing you to the heavens. :) Those who just had their cruise on Independence of the Seas ruined by Noro would have paid a king's ransom for this preventative. Thank you for sharing with us. .... Edited December 18, 2017 by sail7seas Link to comment Share on other sites More sharing options...
jaxonboy Posted December 18, 2017 #11 Share Posted December 18, 2017 We did an overland to Agra, Jaipur, New Delhi. A Gentleman we traveled with came down with India Gut. He was on IV fluids, lost lots of weight, confined to his cabin for 30 days. My wife and I did not get sick. We didn't take anything. Link to comment Share on other sites More sharing options...
Rare TiogaCruiser Posted December 18, 2017 Author #12 Share Posted December 18, 2017 I'm as mystified by the link as you are. Roy Count me in on the confused too. The link I posted from Medscape was really long, too. Link to comment Share on other sites More sharing options...
Rare TiogaCruiser Posted December 18, 2017 Author #13 Share Posted December 18, 2017 I saw this on the link you posted: Traveler's Diarrhea Prophylaxis 2 tablets (262 mg/tab) q6hr for up to 3 weeks I may consider this on my Alaska cruise as long as I can take the caplets. The liquid and the chewables make me throw up. Bismuth is effective against some bacteria. I’ve been aware of it providing some protection against some sub types of shigella. There have been several studies that show prevention, (off label use) but I was surprised to see it actually come out in evidence based guidelines. Q6hr means “every 6 hours”. Link to comment Share on other sites More sharing options...
wander Posted December 19, 2017 #14 Share Posted December 19, 2017 New??? When I was camping on the Sinai Desert in the mid 1980s the recommendation was to chew (or take) Bismuth tablets several times a day for the time on the Desert. PLUS, it was recommended for any travel in places where the food was a potential issue. Doing a lot of travel to what historically were called "third world countries" that has been my regimen. Only problems have been tounge surface turning dark as do some things leaving your body. I do not recall ever using it for more than a few weeks at a time - but unsure of that. Apparently for me at least it really worked - no significant GI problems in all my travels. (Keeping in mind it will not impact viral illnesses, including Noro.) Caveat - I do not eat true "street food" in many places - seems like a larger risk than I want to take when spending money to travel. Tiogacruiser - I personally would not worry about Bismuth in Alaska. It really is quite a civilized place in terms of food, despite the impression some TV tales might show, unless you take it in your own hometown and Lower 48 cities. Sure you can acquire ills eating anywhere - but Alaska it truly equivalent to the lower 48 unless you are into hunting and eating things such as Bear, but the same applies to wild Venison someone "Killed", dressed and ate in New York, Montana, etc. Link to comment Share on other sites More sharing options...
Rare cruisemom42 Posted December 19, 2017 #15 Share Posted December 19, 2017 New??? When I was camping on the Sinai Desert in the mid 1980s the recommendation was to chew (or take) Bismuth tablets several times a day for the time on the Desert. PLUS, it was recommended for any travel in places where the food was a potential issue. Same here -- my travel doc recommended this as long as 14 years ago on my first trip to Egypt. Link to comment Share on other sites More sharing options...
sail7seas Posted December 19, 2017 #16 Share Posted December 19, 2017 Same here -- my travel doc recommended this as long as 14 years ago on my first trip to Egypt. Did it, does it work for you? Link to comment Share on other sites More sharing options...
Rare cruisemom42 Posted December 20, 2017 #17 Share Posted December 20, 2017 Did it, does it work for you? Although I have taken the chewable version with me on some trips (e.g., Egypt, Tunisia) as a potential preventative, I've not used them. My idea -- possibly wrong-headed -- was that I'd wait until I felt any little upset or twinge before I'd start them. So far that hasn't happened. Link to comment Share on other sites More sharing options...
Rare Keith1010 Posted December 20, 2017 #18 Share Posted December 20, 2017 Appreciate the information. Keith Link to comment Share on other sites More sharing options...
ger_77 Posted December 20, 2017 #19 Share Posted December 20, 2017 Although I have taken the chewable version with me on some trips (e.g., Egypt, Tunisia) as a potential preventative, I've not used them. My idea -- possibly wrong-headed -- was that I'd wait until I felt any little upset or twinge before I'd start them. So far that hasn't happened. The key word here is "prevention" - once you've got the upset feeling, you're past preventing it, now you're into the treatment stage. The only thing you can hope is it runs it's course (sorry, no pun intended) quickly! Smooth Sailing! :) :) :) Link to comment Share on other sites More sharing options...
Rare cruisemom42 Posted December 20, 2017 #20 Share Posted December 20, 2017 The key word here is "prevention" - once you've got the upset feeling, you're past preventing it, now you're into the treatment stage. The only thing you can hope is it runs it's course (sorry, no pun intended) quickly!Smooth Sailing! :) :) :) I know. But given my history of not having any stomach issues when traveling, I would be a poor candidate to take it proactively. ;) Link to comment Share on other sites More sharing options...
Rare Gail & Marty sailing away Posted December 20, 2017 #21 Share Posted December 20, 2017 Problem is you are not supposed to take it for more then two days: https://reference.medscape.com/drug/kaopectate-pepto-bismol-bismuth-subsalicylate-342037 That could be a problem. Link to comment Share on other sites More sharing options...
wander Posted December 20, 2017 #22 Share Posted December 20, 2017 I've never heard of the 2 days before - 2 weeks has been my experience. Like some other meds used as a preventative - once the symptoms start it is too late to use as a preventative measure, which is the purpose of use as a prophylaxis. Otherwise it is NOT being used as a Prophylaxis, but treatment as others have mentioned. While it may help shorten the course of the symptoms, they are still there. Does it work? Well, that is hard to say, but what I can say, after using it as a Prophylaxis for well over 100 days totally, for travel in less developed countries - I have NEVER had significant GI problems. Does the Bismuth get the credit - hard to tell as I may not have had any problems without it. I only know that some of the folks I have traveled with did get serious problems, I did not. Of course, as soon as I say this perhaps my "luck" will change, but I will still take Pepto pills to use at times on future cruises in some ports where I may be eating or drinking beverages which include local water. Link to comment Share on other sites More sharing options...
haladdict Posted December 20, 2017 #23 Share Posted December 20, 2017 Washing hands properly is cheaper, faster and is better than ''snake oil'' Sandra Link to comment Share on other sites More sharing options...
Rare cruisemom42 Posted December 20, 2017 #24 Share Posted December 20, 2017 Washing hands properly is cheaper, faster and is better than ''snake oil''Sandra Not sure I'd call a recommendation from the International Society of Travel Medicine "snake oil". :confused: And washing hands won't help if you've eaten tainted food or water. Link to comment Share on other sites More sharing options...
Rare Hlitner Posted December 20, 2017 #25 Share Posted December 20, 2017 My goodness, all this just about Pepto Bismol. This product has been a travelers friend for decades. But taking it on a routine basis for prevention does have its drawbacks so consider this info on possible side-effects: Applies to bismuth subsalicylate: oral suspension, oral tablet, oral tablet chewable Along with its needed effects, bismuth subsalicylate may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention. Check with your doctor immediately if any of the following side effects occur while taking bismuth subsalicylate: In some patients bismuth subsalicylate may cause dark tongue and/or grayish black stools. This is only temporary and will go away when you Stop taking bismuth subsalicylate. Anxiety any loss of hearing confusion constipation (severe) diarrhea (severe or continuing) difficulty in speaking or slurred speech dizziness or lightheadedness drowsiness (severe) fast or deep breathing headache (severe or continuing) increased sweating increased thirst mental depression muscle spasms (especially of face, neck, and back) muscle weakness nausea or vomiting (severe or continuing) ringing or buzzing in ears (continuing) stomach pain (severe or continuing) trembling uncontrollable flapping movements of the hands (especially in elderly patients) or other uncontrolled body movements vision problems When I worked as a Paramedic back in the 70s and early 80s I actually had two cases (one while working in the ER and the other out in the field) of Pepto Bismol related problems. Neither was particularly serious, but one did result in calling an ambulance and the other person was carried into the ER. Go figure. Hank Link to comment Share on other sites More sharing options...
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