Relevant Studies Involving Bismuth in Diarrhea Management.
Relevant Studies Involving Bismuth in Diarrhea Management.
| Author (Year), Reference | Study Design | Population | Parameters Observed | Conclusions |
|---|---|---|---|---|
| Fine & Lee (1998)5 | Prospective cohort | 13 MC patients (7 with subepithelial collagen deposition and 6 without) | Stool, histological analysis, blood tests | Eight-week BSS treatment is an effective intervention for MC |
| Gentile et al. (2015)16 | Retrospective | 64 MC patients | Response rate based on baseline diarrhea severity | MC patients treated with BSS had a strong response rate, but they were also at high risk to have recurrence |
| Steffen et al. (1988)17 | RDB, parallel study | 245 tourists with traveler’s diarrhea | Stool timing, stool consistency, number of stools, relief of therapy timing | BSS was well tolerated and effective in shortening the duration of traveler’s diarrhea |
| Steffen et al. (1986)18 | RDB study | 390 travelers (aged 16–70 y) going to a developing country | Incidence of diarrhea, microbiological results | Incidence of diarrhea in the treatment groups was significantly lower than in the placebo group, and bacteria was only found in the stools of the placebo group |
| DuPont et al. (1987)19 | Randomized, placebo-controlled trial | 182 students from USA in Mexico | Development of diarrheal illness, occurrence of mild illness, protection rate, pathogen in stool | Overall, BSS was an effective and safe treatment to reduce the occurrence of traveler’s diarrhea |
| DuPont et al. (1980)20 | RDB placebo-controlled study | 150 students traveling to Mexico | Occurrence of diarrhea, mild changes in stool form, enteropathogen detection | There was a protective effect of BSS on occurrence of diarrhea and infection with enteropathogens |
| Johnson et al. (1986)21 | Randomized trial | 296 adult students diagnosed with acute diarrhea | Number of unformed stools by hour, response to therapy, symptomatic relief | For treatment of traveler’s diarrhea, loperamide is an effective alternative to BSS; the median number of unformed stools was less in subjects taking loperamide compared to BSS |
| Graham et al. (1983)22 | RDB placebo-controlled study | 32 healthy volunteers inoculated with enterotoxigenic E. coli | Development of diarrhea, symptomatic response, stool weight, stool frequency, antibody titer | BSS can be effective in prevention of traveler’s diarrhea |
| Hansen & Penkowa (2017)23 | RDB, prospective pilot study | 50 hematological inpatients | Duration of diarrhea and gender-linked incidence | In lymphoma patients, bismuth significantly reduces diarrhea relative to placebo |
| Zaveri et al. (2018)24 | Prospective RDB, placebo-controlled, crossover study | 36 patients with flatus and/or stool odor changes who were at least 6 months post-loop duodenal switch | Gastrointestinal Quality of Life Index (GIQLI) questionnaire | For the treatment group GIQLI overall scores and digestive scores were significantly higher after treatment; quality of life after the treatment with bismuth was significantly higher compared to pre-treatment and post-placebo |
| Daghaghzadeh, et al. (2018)25 | Placebo-controlled clinical trial | 129 IBS patients with three subtypes: IBS-constipation dominant (IBS-C), IBS-diarrhea dominant (IBS-D), and IBS-mixed (IBS-M) | IBS-related questionnaires, IBS-severity scoring system | Quality of life significantly improved in IBS-D from study beginning to end; bismuth had a significant effect on improvement of IBS-D patient symptoms |
| Hernández et al. (2015)26 | Prospective, observational study | 65 patients undergoing biliopancreatic diversion with Scopinaro’s classic technique | Gastrointestinal Quality of Life Index (GIQLI) questionnaire, nutritional status | All domains of the GIQLI were significantly higher after bismuth treatment than before treatment; in patients undergoing Scopinaro’s biliopancreatic diversion, bismuth subgallate was effective for short-term treatment of unfavorable symptoms |
| DuPont et al. (1990)27 | Open-label, parallel comparison study | 203 adult students from USA or Mexico diagnosed as having acute, non-specific diarrhea | Average number of unformed stools, stool frequency, time to last unformed stool (TTLUS), time to first unformed stool (TTFUS), percent of participants with no additional loose stools and requiring no additional doses | Loperamide is more effective for acute non-specific diarrhea relief than BSS; mean TTLUS was lower for loperamide and median TTFUS was longer; loperamide patients overall required fewer doses compared to BSS patients |