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Is Pepto-Bismol safe for kids?
Q: I was wondering about treatment for my 3-year-old daughter when she gets diarrhea. When I get diarrhea, I take Pepto-Bismol. Can I give this to her?
A: Marlena, it’s good you asked this question, because many medications that are safe for adults may not be safe for children. In fact, the U.S. Food and Drug Administration (FDA) just completed a review of the safety and effectiveness of anti-diarrhea medicines for children and adults.

Pepto-Bismol has the active ingredient bismuth subsalicylate, which has been found to be safe and effective for treating “nonspecific diarrhea” in adults. However, bismuth subsalicylate is chemically related to aspirin (acetylsalicylate), which can be dangerous for children. When given during a viral illness, it can cause Reye’s Syndrome, a rare condition that can involve serious brain damage. For this reason, products containing bismuth subsalicylate must carry the following warning on the label: “Children and teenagers should not use this medicine for chicken pox or flu symptoms before a doctor is consulted about Reye's syndrome, a rare but serious illness reported to be associated with aspirin.” In addition, recent studies have not found these medicines to be effective in children under 12.

Diarrhea in young children is usually caused by one of many different types of viruses that can infect the stomach and intestines causing nausea, stomachache, vomiting, diarrhea and fever. People often call it “stomach flu” though it’s not related to the “flu” or influenza virus that causes cough and fever. The important thing to know about these stomach/intestinal virus infections is that the symptoms typically last from one to three days and the child gets better on her own without medicine. It’s best to help your child’s own body recover by giving her plenty of clear fluids (water, chicken broth, ginger ale, white grape juice, Popsicles, etc.) to prevent dehydration, and bland food such as bananas, rice, applesauce and dry toast to help firm up the stools and bring back her energy.

Karen Sokal-Gutierrez M.D., M.P.H. Pediatrician