Melanosis Coli: Diagnosis, Clinical Significance, and Prognosis in Colorectal Screening

Document Type : Case Report

Authors

1 Department of Internal Medicine, University of Arkansas for Medical Sciences, Northwest Regional Campus, Fayetteville, Arkansas, United States

2 Department of Gastroenterology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, United States

3 University of Arkansas for Medical Sciences, College of Medicine, Fayetteville, Arkansas, United States

Abstract

Melanosis coli is a generally benign condition characterized by brown-black pigmentation of the colonic
mucosa. It is classically associated with the prolonged use of anthraquinone laxatives, with senna and cascara
being the most commonly utilized agents. The accumulation of the pigment lipofuscin within macrophages in
the colonic lamina propria has been observed with long-term use of anthranoid laxatives. This phenomenon is
consistent with the classic discoloration of the colon for which this condition is known, often observed during
colonoscopy. The following case report focuses on a 55-year-old woman with a medical history that includes
hypertension, uterine hypertrophy, menorrhagia, migraine, and constipation, who presented for a screening
colonoscopy. It addresses the challenges in diagnosing melanosis coli and discusses its clinical significance
based on a review of the relevant literature. This case review and literature search summarize information
regarding the management and prognosis of melanosis coli in the context of colorectal cancer screening and
the detection of adenomas.

Highlights

Sahil Sabharwal (Google Scholar)

Keywords

References

1. Ezike, K., Okwudire-Ejeh, I., Salu,
I., Nnabuchi, C., Aghahowa, M. E.,
Ani, F. O., & Isaac, H. M. (2023).
Biopsy-proven melanosis coli
initially diagnosed as candidiasis on
colonoscopy: A report of two cases
from North Central Nigeria. Cureus.
2. Kuriyama, A. (2021). Melanosis coli.
JMA Journal.
3. Blackett, J. W., Rosenberg, R., Mahadev,
S., Green, P. H. R., & Lebwohl, B.
(2018). Adenoma Detection is Increased
in the Setting of Melanosis Coli.
Journal of clinical gastroenterology,
52(4), 313–318. https://doi.org/10.1097/
MCG.0000000000000756
4. Tsobanidou C.h (2005). Melanosis
coli in two patients with colorectal
neoplasia. Journal of B.U.ON. :
official journal of the Balkan Union
of Oncology, 10(1), 131–133.
5. Nusko, G., Schneider, B., Ernst,
H., Wittekind, C., & Hahn, E. G.
(1997). Melanosis coli--a harmless
pigmentation or a precancerous
condition?. Zeitschrift fur
Gastroenterologie, 35(5), 313–318.
6. Blackett, J. W., Rosenberg, R.,
Mahadev, S., Green, P., & Lebwohl,
B. (2016). Adenoma detection
is increased in the setting of
melanosis coli. Journal of Clinical
Gastroenterology.
7. Abu Baker, F., Mari, A., Feldman,
D., Suki, M., Gal, O., & Kopelman,
Y. (2018). Melanosis coli: A
helpful contrast effect or a harmful
pigmentation? Clinical Medicine
Insights: Gastroenterology.
8. Kew, S., & Chakravarthi, S. (2013).
Images in clinical medicine:
Melanosis coli. The New England
Journal of Medicine.
9. Lo, C. M., Chen, C. C., Yeh, Y. H.,
Chang, C., & Yeh, H. J. (2020).
Quantitative analysis of melanosis
coli colonic mucosa using textural
patterns. Applied Sciences.
10. Zapatier, J., Schneider, A., & Parra, J.
(2010). Overestimation of ulcerative
colitis due to melanosis coli. Acta
Gastroenterologica Latinoamericana.
11. Kassim, S. A., Abbas, M., Tang,
W., Wu, S., Meng, Q., Zhang, C.,
Naeem, S., Li, X., & Chen, R. (2019).
Retrospective study on melanosis coli
as risk factor of colorectal neoplasm:
A 3-year colonoscopic finding in
Zhuhai Hospital, China. International
Journal of Colorectal Disease.
Iranian Journal of Colorectal Research
Volume 12, Issue 4
December 2024
Pages 128-132

Files

Share

How to cite

Statistics