Does Pepto Bismol Make You Poop? Read This Before You Pop the Pink Bottle

Eating black licorice, blueberries, blood sausage or taking iron pills, activated charcoal, or medicines that contain bismuth (such as Pepto-Bismol), can also cause black stools. Beets and foods with red coloring can sometimes make stools appear reddish. In all these cases, your doctor can test the stool with a chemical to rule out the presence of blood. Bleeding in the esophagus or stomach (such as with peptic ulcer disease) can also cause you to vomit blood.

Bloody or tarry stools

Black or tarry stools with a foul smell are a sign of a problem in the upper digestive tract. It most often indicates that there is bleeding in the stomach, small intestine, or right side of the colon. The term melena is used to describe this finding.

The process of digesting food is accomplished by many organs in the body. Food is pushed by the esophagus into the stomach. The stomach mixes the food and begins the breakdown of proteins. The stomach propels the food then into the small intestine. The small intestine further digests food and begins the absorption of nutrients. Secretions from the pancreas in the small intestine help neutralize the acid in the intestine to provide a proper environment for the enzymes to function. Bile from the gallbladder and liver emulsify fat and enhance the absorption of fatty acids. The large intestine temporarily stores and concentrates the remainder until it is passed out as waste from the body.

Peptic ulcers may lead to emergency situations. Severe abdominal pain with or without evidence of bleeding may indicate a perforation of the ulcer through the stomach or duodenum. Vomiting of a substance that resembles coffee grounds, or the presence of black tarry stools, may indicate serious bleeding.

A Mallory-Weiss tear results from prolonged and forceful vomiting, coughing or convulsions. Typically the mucous membrane at the junction of the esophagus and the stomach develops lacerations which bleed, evident by bright red blood in vomitus, or bloody stools. It may occur as a result of excessive alcohol ingestion. This is an acute condition which usually resolves within 10 days without special treatment.

Capsule endoscopy is a test procedure in which a camera inside a small capsule takes pictures of the lining of your digestive system. The capsule is about the size of a large vitamin pill. After swallowing it, the capsule travels the length of your digestive system and transmits images to a wearable recorder.

Considerations

Eating black licorice, blueberries, blood sausage or taking iron pills, activated charcoal, or medicines that contain bismuth (such as Pepto-Bismol), can also cause black stools. Beets and foods with red coloring can sometimes make stools appear reddish. In all these cases, your doctor can test the stool with a chemical to rule out the presence of blood. Bleeding in the esophagus or stomach (such as with peptic ulcer disease) can also cause you to vomit blood.

Causes

• Black or tarry stools may be due to bleeding in the upper part of the GI (gastrointestinal) tract, such as the esophagus, stomach, or the first part of the small intestine. In this case, blood is darker because it gets digested on its way through the GI tract.
• Red or fresh blood in the stools (rectal bleeding), is a sign of bleeding from the lower GI tract (rectum and anus).

Peptic ulcers are the most common cause of acute upper GI bleeding. Black and tarry stools may also occur due to:

• Abnormal blood vessels in the esophagus, stomach, or duodenum
• A tear in the esophagus from violent vomiting (Mallory-Weiss tear)
• Blood supply being cut off to part of the intestines
• Inflammation of the stomach lining (gastritis)
• Trauma or foreign body
• Widened, overgrown veins (called varices) in the esophagus and stomach, commonly caused by liver cirrhosis
• Cancer of the esophagus, stomach, duodenum, or ampulla of Vater

When to Contact a Medical Professional

Contact your health care provider right away if:

• You notice blood or changes in the color of your stool
• You vomit blood
• You feel dizzy or lightheaded

In children, a small amount of blood in the stool is most often not serious. The most common cause is constipation. You should still tell your child’s provider if you notice this problem.

What to Expect at Your Office Visit

Your provider will take a medical history and perform a physical exam. The exam will focus on your abdomen.

You may be asked the following questions:

• Are you taking blood thinners, such as aspirin, warfarin, Eliquis, Pradaxa, Xarelto, or clopidogrel, or similar medicines? Are you taking an NSAID, such as ibuprofen or naproxen?
• Have you had any trauma or swallowed a foreign object accidentally?
• Have you eaten black licorice, lead, Pepto-Bismol, or blueberries?
• Have you had more than one episode of blood in your stool? Is every stool this way?
• Have you lost any weight recently?
• Is there blood on the toilet paper only?
• What color is the stool?
• When did the problem develop?
• What other symptoms are present (abdominal pain, vomiting blood, bloating, excessive gas, diarrhea, or fever)?

You may need to have one or more tests to look for the cause:

• Angiography
• Bleeding scan (nuclear medicine)
• Blood studies, including a complete blood count (CBC) and differential, serum chemistries, clotting studies
• Colonoscopy
• Esophagogastroduodenoscopy or EGD
• Stool culture
• Tests for the presence of Helicobacter pylori infection
• Capsule endoscopy (a pill with a built in camera that takes a video of the small intestine)
• Double balloon enteroscopy (a scope that can reach the parts of the small intestine that are not able to be reached with EGD or colonoscopy)

Severe cases of bleeding that cause excessive blood loss and a drop in blood pressure may require surgery or hospitalization.

References

Chaptini L, Peikin S. Gastrointestinal bleeding. In: Parrillo JE, Dellinger RP, eds. Critical Care Medicine: Principles of Diagnosis and Management in the Adult. 5th ed. Philadelphia, PA: Elsevier; 2019:chap 72.

DeGeorge LM, Nable JV. Gastrointestinal bleeding. In: Walls RM, ed. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 26.

Kovacs TO, Jensen DM. Gastrointestinal hemorrhage. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 126.

Savides TJ, Jensen DM. Gastrointestinal bleeding. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran’s Gastrointestinal and Liver Disease. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 20.

Version Info

Last reviewed on: 5/4/2022

Reviewed by: Michael M. Phillips, MD, Emeritus Professor of Medicine, The George Washington University School of Medicine, Washington, DC. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

Does Pepto Bismol Make You Poop? Read This Before You Pop the Pink Bottle

If you’ve ever done serious damage at a buffet table or experienced the wrath of food poisoning, you might have found yourself reaching for a trusty pink bottle of Pepto Bismol. This concoction is designed to settle your stomach and tame spasms, but the last thing you need is a bowel blowout when you least expect it.

This leads to an important question: Does Pepto Bismol make you poop? The short answer is: probably not. In fact, it can actually bulk up your stool to the point that it makes it harder to push out (more on that later).

In this article, we’ll break down what Pepto Bismol does to your gut and how it affects your pooping patterns so you’re not caught off guard by any surprises during your next bathroom visit.

Does Pepto Bismol Make You Poop?

No, Pepto Bismol probably won’t make you poop since it’s not a laxative. On the contrary, Pepto Bismol increases the amount of fluid that’s absorbed into your intestines, which thickens your stool.

That’s because of the main active ingredient, bismuth subsalicylate. This stuff reduces inflammation in the gastrointestinal tract and binds to excess water, giving your poop a more solid consistency.

Bottom line: Pepto Bismol does the opposite job of a laxative.

If you’re plugged up and haven’t pooped in a while, there’s a good chance you’re dealing with bloating, cramping, and horrific farts. This might tempt you to take a swig of Pepto to find sweet relief. But that can actually make your constipation worse thanks to Pepto’s antidiarrheal effects.

Instead of Pepto Bismol, take a laxative, increase your fiber intake, and stay hydrated—these should kick your colon into high gear.

What Does Pepto Bismol Do To Your Gut?

In case you forgot their classic jingle from the early 2000s, Pepto Bismol is designed to relieve nausea, heartburn, indigestion, upset stomach, and diarrhea. Also called “the pink stuff,” Pepto Bismol is an over-the-counter (OTC) medication that’s safe and effective for temporary use.

The scientific name for the active ingredient in Pepto-Bismol is bismuth subsalicylate. Let’s break that down in DUDE language:

• Bismuth is a mineral that has antibacterial, antacid, and antidiarrheal effects
• Subsalicylate is an anti-inflammatory medication in the same class as aspirin

The most popular form of Pepto is the iconic pink liquid, but it also comes in chewable tablets with the same ingredients.

When you take Pepto Bismol, the bismuth subsalicylate coats the lining of your stomach and intestines, forming a protective barrier against irritants and pathogens. It also reduces inflammation, stops spasms, and reduces excess levels of stomach acid.

A single dose of Pepto Bismol usually takes 30-60 minutes to kick in—butt there’s a weird side effect to watch out for on the toilet.

Does Pepto Bismol Turn Your Poop Black?

If you take Pepto Bismol, there’s a decent chance you’ll drop a black turd in the toilet. Black stools happen because of the interaction between bismuth subsalicylate and the sulfur compounds in your gut.

As Pepto Bismol works its way through your digestive tract, it undergoes a chemical reaction that forms sulfide compounds, which add a touch of noir to your otherwise boring bowel movements.

Don’t panic. Pepto’s black poop effect is temporary and you should go back to brown after a day or two.

Aside from changing the color of your crap, common side effects of Pepto Bismol include a black tongue, constipation, and bowel blockage (although that one’s super rare).

Can Pepto Bismol Make You Constipated?

We get it—you bought this pink potion to solve your gut problems. But the unfortunate answer is yes, it’s possible for Pepto Bismol to cause constipation.

The active ingredient (bismuth subsalicylate) is designed to stop diarrhea. Butt sometimes, the medication does an overcorrection and stiffens up your stool to the point that it can’t escape.

Pepto Bismol has absorbent properties and binds to excess fluids in your gut. This is necessary to stop the runs, but it can also make your stool hard and dry. Additionally, the anti-inflammatory and antimicrobial properties of Pepto can affect the muscle contractions of your intestines. If these contractions slow down, it can slow down the movement of stool through the digestive system, leading to constipation.

Don’t let the potential for getting plugged up scare you away. Everyone reacts differently to Pepto Bismol, and even if you do get constipated, the effects should subside after a day or two.

Pepto Prevents Diarrhea. We Clean It Up.

Pepto Bismol has been stopping diarrhea for more than a hundred years. The pink potion has done more than enough to earn a spot in your bathroom cabinet. But while you’re waiting for it to kick in, you better make sure you’ve got the proper cleanup material on hand for those Hershey Squirts.

Whether you’re dealing with the aftermath of all-you-can-eat wings or just a standard daily dump, your butthole deserves DUDE Wipes. Infused with aloe and vitamin E, these XL wipes don’t just clean your crack—they give it the spa-like treatment it deserves.

Next time you’re at the store picking up Pepto, make a detour to the TP aisle and grab a pack of DUDE Wipes.