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This summary is machine-generated.

Bismuth subsalicylate treatment in an elderly woman with collagenous colitis led to severe tremors, cognitive deficits, and falls due to elevated bismuth levels. Discontinuing the medication resulted in significant recovery, highlighting bismuth toxicity risks.

Keywords:
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Area of Science:

  • Geriatric Medicine
  • Neurotoxicology
  • Gastroenterology

Background:

  • Collagenous colitis is an inflammatory bowel disease.
  • Bismuth subsalicylate is a common treatment for gastrointestinal issues.
  • Elderly patients may be more susceptible to medication side effects.

Purpose of the Study:

  • To report a case of bismuth toxicity presenting as neurological and physical decline.
  • To investigate the link between bismuth subsalicylate treatment and adverse symptoms in an elderly patient.

Main Methods:

  • Case report of a 77-year-old woman with collagenous colitis.
  • Clinical examination revealing impaired balance, gait, tremors, and cognitive deficits.
  • Laboratory investigation of urinary bismuth levels.
  • Monitoring of patient's condition after bismuth subsalicylate withdrawal.

Main Results:

  • Markedly elevated urinary bismuth levels were detected.
  • The patient experienced significant improvement in cognitive function and physical mobility after discontinuing bismuth subsalicylate.
  • Symptoms were directly attributed to bismuth accumulation and toxicity.

Conclusions:

  • Bismuth subsalicylate can cause toxicity, particularly in the elderly, manifesting as neurological and physical impairment.
  • Monitoring bismuth levels is crucial in patients on long-term treatment, especially older adults.
  • Prompt recognition and withdrawal of the offending agent can lead to substantial recovery.