Transmucosal penetration of bismuth particles in the human stomach.

Electron microscopic examination of upper gastrointestinal biopsies with x-ray microanalysis was used to detect electron-dense particles of bismuth in the mucosa of the upper gastrointestinal tract, 30-60 minutes after oral dosing with either tripotassium dicitrato bismuthate [De-Noltab; Brocades (Great Britain) Ltd., Weybridge, UK; five patients] or bismuth salicylate (Pepto-Bismol; Richardson Vicks Ltd., Egham, UK; five patients), or without dosing (two patients). Transmucosal penetration of bismuth particles was observed in the gastric antral mucosa of all patients who had been dosed with tripotassium dicitrato bismuthate, but there was no penetration after oral dosing with bismuth salicylate. Persorption of bismuth particles through the gastric mucosa to the vascular endothelium provides an explanation for the rapid rise of plasma bismuth concentration observed only after oral dosing with tripotassium dicitrato bismuthate.