Bismuth toxicity--a reassessment

Bismuth compounds, in particular bismuth subsalicylate and colloidal bismuth subcitrate, are now being actively promoted for the treatment of diarrhoea and peptic ulcer disease. The past history of the therapeutic use of bismuth compounds has been marred by episodes of serious adverse reactions. Salicylism is a possible complication with bismuth subsalicylate. This article reviews the pertinent literature on the reported adverse reactions to bismuth compounds to provide the necessary background to assess the value of bismuth subcitrate and bismuth subsalicylate as therapeutic compounds.