1) PG-13 Horror Films Can Be Scary
2) An R-rating doesn't equal a scary (or even good) horror film
3) PG-13 movies can be graphic
In a few seconds, you'll hear the only fart-like sound in this PG rated move.
4) Gore is becoming more acceptable
TV has changed.
5) Lovecraft's story isn't gory
6) The MPAA might not be a problem
All del Toro has to do is find a way to include a scene like this in the film.
The MPAA will freak out and allow anything else to stay in, as long as Eva Green's breast is out of the picture.