It is a salicylate, so if you are allergic or sensitive to them, you should avoid it. Also, the same caution as aspirin applies to using it in the pediatric population during viral infections.

However, it is NOT in the same class as NSAIDs. It is specifically to treat GI disorders, so it is OK.

Jan

thank you so much jan...

Pepto Bismol (bismuth salicylate) is also a weak antibiotic, so don't be fooled into thinking you're "avoiding medication" by using it.

I suspect there's not great data about any possible connection between chronic Pepto Bismol use and pouchitis (as there is with NSAIDs). Many months ago I asked this group if anyone knew whether aspirin presented us with the same problems as the other NSAIDs (which are really very different drugs), and no one responded, probably because so few use aspirin. I'd suspect even Bo Shen doesn't really know, though he might have a very educated guess.

Sorry Scott. I must have missed your prior post. But, yeah, aspirin is an NSAID, with al, the same side effects and precautions. It is in a little different category, since the pain relief is through different pathways, but the gut effect is essentially the same, if not worse, than ibuprofen and similar drugs. It also permanently disables platelets and that is why you have to stop taking it much earlier than other NSAIDs before surgery.

I suppose that not much is said about it because it just is not used long term for pain and arthritis, since the risk of GI bleeding is so high, compared to the other NSAIDs.

http://en.wikipedia.org/wiki/Aspirin

Jan

Aspirin sure does have the same gut effect as other NSAIDs on factors like upper GI ulceration. I think it's less clear why NSAIDs exacerbate or cause pouchitis, which seems very different from a peptic ulcer or gastritis. In any case, the category NSAIDs has some subgroups that behave quite differently in some ways. The COX-2 inhibitors really do act differently, for example.

My point is simply that the various NSAIDs won't have been studied individually, or even as subclasses, so they have to be lumped together in the advice about their use, even if that's not what's actually going on. The fact that aspirin reduces inflammation and isn't a steroid makes it an NSAID, but I'm avoiding it because of the company it keeps rather than because anyone actually knows how aspirin behaves specifically.

I don't disagree with the general advice, since it's the best anyone can do, but I think there's plenty of hand-waving behind it.

Why is it that my colorectal surgeon told me it is now okay for me to take NSAIDS since I no longer have a colon? I have from time to time and have not had a negative or positive experience.

NSAID use turns out to be a contributing factor in pouchitis. Occasional use is probably fine, but regular use seems to get J-pouchers in trouble.

It is just another example that "never and always" just do not apply when it comes to drug side effects. The exception is that you should never assume something is safe for you or always assume it is a danger.

I was able to tolerate high dose NSAIDs both before and after colectomy, for many years. That is until I developed side effects. Now I limit use to two week intervals. Sometimes I just need something more than my routine meds.

Jan

so is pepto safe for chronic pouchitis?

I believe so, as long as you do not take large doses over a long period of time. The most likely issue is that it would not be helpful. It is certainly worth trying though!

Jan

thanks again jan. my dose would be half a caplet 4 to 6 times a day. can the antibiotic effects wear off like prescription antibiotics can?

Your dose seems fine, but just know that there is little information out there for long term use. The one and only real concern is possible bismuth poisoning. This is very rare and only documented in those taking high doses and at higher risk (elderly or very young). Still, if you develop any neurological symptoms, you should take a second look at your Pepto Bismol. The good news is that it is reversible by just stopping the treatment. Bottom line is to take the lowest dose and frequency that works.

Sure, resistance can occur, but this is not really an antibiotic in the same sense as typical antibiotics. The good thing about it is that it is useful for C. diff prevention and to keep down bacterial overgrowth of "bad actor" bacteria. It also absorbs bacterial toxins.

Jan

quote:

posted May 6, 7:32 PM Hide Post
Why is it that my colorectal surgeon told me it is now okay for me to take NSAIDS since I no longer have a colon? I have from time to time and have not had a negative or positive experience.

Apparently your Surgeon either doesn't know or doesn't care about the impact NSAID's could have on your pouch. Not everyone has a negative side effect from taking them, but, I'd suspect over time at some point all of us would have negative side effects from taking them. Just my $0.02 (As with anything, we are all affected differently by different things!)