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Mark Pimentel developed a breath test called TrioSmart that detects hydrogen sulfide producing bacterial overgrowth. He promotes the use of Xifaxan plus Pepto Bismol to treat these patients who tend to have problems with diarrhea and abdominal pain. It seems that about a quarter of H2S producing patients are constipated, instead of having diarrhea. I have found that a low carb diet corrects this H2S bacterial overgrowth even if you don’t treat with antibiotics and Pepto Bismol. But then again, a low carb diet corrects insulin resistance. Maybe it works because it causes the H2S producing bacteria to wither away.

David Martin

Gastroenterologist

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Thank you for this insight David. Very interesting.

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Very interesting. But since some readers of this post may be tempted to take Pepto-Bismol as a remedy, they might first want to consider this March 2024 NYT Magazine article about a patient whose chronic use of Pepto-Bismol apparently made him gravely ill. https://www.nytimes.com/2024/03/07/magazine/bismuth-toxicity-pepto-bismol.html

Just because something is approved for sale OTC doesn't mean it's necessarily safe for long-term use.

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Agreed. Something I'm learning (perhaps too slowly as my public presence grows), is how much common sense is sometimes lacking and caveats that I don't think should be required should be included...

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Thanks Nick! So how much Pepto Bismol a day to treat the presence of hydrogen sulfide?

(While also eating a low carb diet)

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Thanks Nic

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