Radiopaque Bismuth in Colon (Pepto-Bismol®)

Ray Ballinger, MD, PhD

Straub Clinic and Hospital

rballinger at


77 y/o woman with abdominal pain


plain CT abdomen

Publication Date: 28 October 2003

History and Images

77 y/o woman with abdominal pain. No history of recent diagnostic barium studies.

click to enlargeclick to enlarge


Radiopaque material is seen in the right side of the colon. The enlarged right kidney and dilated collecting system was a result of bleeding from an elevated INR=27. What's in the colon?


Radiopaque Bismuth in Colon (Pepto-Bismol®)


Clinical history


The patient had been drinking copious amounts of Pepto-Bismol® for her abdominal pains. The active ingredient of Pepto-Bismol is bismuth salicylate. Bismuth is a white, crystalline metal with a pinkish tinge. It's atomic number is quite high (83), and is in the same row of the periodic table as barium and lead, hence it's radiopaque properties.


  1. History of Pepto-Bismol®