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Abstract
The influence of colloidal bismuth subcitrate on the concentration of the aerobic faecal microorganisms in patients was investigated. Fifteen patients with Helicobacter pylori related gastritis received colloidal bismuth subcitrate 120 mg four times a day for 2 wk and 14 other patients for 4 wk. A significant increase occurred in the median faecal concentrations of gram-negative bacilli (106-107 CFU/g faeces; P<0001) and enterococci (105-108 CFU/g faeces; P<0001) following 2 wk colloidal bismuth subcitrate. There were no differences in median faecal concentrations of aerobic microorganisms between weeks 2 and 4. Suppression of the indigenous microbiota with colloidal bismuth subcitrate did not cause an increase in the faecal concentration of yeasts. It is concluded that colloidal bismuth subcitrate impairs the autochthonous microbiota that limits the concentration of potentially pathogenic microorganisms, but the resulting increase in the concentration of microorganisms seems too small to be of clinical relevance.