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

10.30476/acrr.2025.105685.1240

Abstract

Melanosis coli is a generally benign condition characterized by brown-black pigmentation of the colonic mucosa. Classically, it presents with prolonged intake of anthraquinone laxative agents. Of these, senna and cascara are the most frequently used anthraquinone laxatives. Accumulation of the pigment lipofuscin within macrophages in the colonic lamina propria has been described with long-term use of anthranoid laxatives. This is consistent with classic discoloration of the colon that this condition is known for, often observed during colonoscopy. The following case report centers around a 55-year-old female with a history of hypertension, uterine hypertrophy, menorrhagia, migraine, and constipation presenting for a screening colonoscopy, and addresses the difficulty in diagnosis and the clinical significance of melanosis coli based on the review of the literature related to the condition. This case review and literature search summarize information regarding management and prognosis of melanosis coli in the setting of colorectal cancer screening and detection of adenomas.

Keywords

Iranian Journal of Colorectal Research
Volume 12, Issue 4
December 2024

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