top of page
Review Articles






AK Jaiswal, Saumya Solanki, Akanksha Priya, Surender Sehrawat, Rajesh Kumar, Rajiv Kumar

ABSTRACT: Bismuth is a chemical element with the symbol Bi and atomic number 83. It is a pentavalent metal which chemically resembles Arsenic (As) and Antimony (Sb). Bismuth salts, especially colloidal bismuth subcitrate (CBS) and bismuth subsalicylate, are widely used to treat peptic ulcers, functional dyspepsia, and chronic gastritis.Bismuth and most of its compounds are less toxic in comparison to other heavy metals like lead, antimony, cadmium, etc. The main organs involved in bismuth poisoning are kidney, liver and bladder. Skin and respiratory irritation can also follow exposure to respective organs. Large concentration of bismuth is contained in kidney and is primarily excreted through this organ while lesser amounts of bismuth are excreted via saliva, milk and bile. Routes of exposure are skin/eye contact, inhalation and ingestion. The toxic results developed by this heavy metal are serious ulcerative stomatitis, vague feeling of bodily discomfort, nausea, vomiting, loss of appetite and weight, pain in legs, arms and joints, depression and sleeplessness, pyorrhea and exodermatitis. Management of the bismuth poisoning is done in the same line as any other heavy metals, with irrigation of the stomach (gastric lavage) and chelating agents.


KEY WORDS: Bismuth, Poisoning, Toxicity, Treatment, Management etc.


  1. Erden, A., A Case of Bismuth Intoxication with irreversible renal damage. Internation Journal of Nephrology and Renovascular Disease 2013; 6:241-243.

  2. Reynolds, P.T., e. Bismuth Toxicity: A Rare Cause of Neurologic Dysfunction. International Journal of Clinical Medicine; 3,4: 46-48.

  3. Ovaska, H., Severe iatrogenic bismuth poisoning with bismuth iodoform paraffin paste treated with DMPS chelation. Clinical Toxicology; 46,9: 855-857.

  4. Tubafard, S., Chelation of bismuth by combining desferrioxamine and deferiprone in rats. Toxicology and Industrial Health; 24: 235-240.

  5. Dodge, A.G., Metabolism of Bismuth Subsalicylate and Intracellular Accumulation of Bismuth by sp. Strain B.Vol. Applied and Environmental Microbiology ;71: 876-882.

  6. Slikkerveer, A. Development of a therapeutic procedure for bismuth intoxication with chelating agents. Journal of Laboratory and Clinical Medicine;119(5):529-537.

  7. Mc Graw Co.Encyclopedia of occupational health and safety, volumes I and II. New York : International Labour Office 1971; 186.

  8. Jaiswal A.K. and Millo T. Handbook of Forensic Analytical Toxicology, 1stedn. New Delhi: jaypee brothers medical publishers ( P) ltd; 2014.

  9. Alaa S. Amin. Spectrophotometric determination of bismuth after solid-phase extraction using amberlite XAD-2 resin modified with 5-(2'-bromophenylazo)-6-hydroxypyrimidine-2,4-dione. Journal of Taibah University for Science 2015; 490-497.

bottom of page