Prognosis in Patients with Melanosis Coli; A Prospective Study

Abstract

Introduction:Melanosis coli is a benign lesion associated with the overuse of laxatives containing anthraquinone. The aim of this study is to determine whether melanosis recovers after the discontinuation of laxatives and whether this condition is associated with a higher incidence of colon polyps or cancer compared to the general population.Methods:Patients with confirmed melanosis coli were performed a repeat colonoscopy and biopsy 2 years later and their histopathological examination results were compared. Data on age, sex, the use of any medicinal laxative or herbals, the presence of findings after the discontinuation of laxatives, constipation, colon polyp, and the relationship with colon cancer were examined. The similarity of segments and their relationships in the first and control colonoscopies were investigated in cases detected to have melanosis coli.Results:All 104 patients included in the study were suffering from constipation. While the number of patients using laxatives or herbal tea was initially 96, it was 24 at the time of follow-up colonoscopy. Although the majority of subjects had discontinued laxatives, histological findings of melanosis coli persisted in 88 of 104 subjects. Mostly descending colon and rectum were involved.Conclusion:It is thought that the findings of melanosis coli disappear in about 6 months following the discontinuation of laxative drugs and herbal teas. However, it was detected in our series that while the macroscopic findings were mostly healed even in the follow-up after two years, microscopic findings of melanosis coli continued to remain. No relationship was found between melanosis coli and the development of colon cancer and polyp. In the present study, it was aimed to emphasize that melanosis coli’s becoming chronic and its creating a predisposition to colon cancer should be investigated with longer follow-ups and some herbal teas may cause a long-term change in the colon mucosa.

Keywords

• Melanosis coli
• constipation
• colonoscopy
• hyperpigmentation