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. 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.

Keywords

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

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