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Anthranoid self-medication causing rapid development of melanosis coli
M Willems1, H R van Buuren, R de Krijger
1Department of Gastroenterology and Hepatology (Ca 415), Erasmus Medical Centre, PO Box 2040, 3000 CA Rotterdam, The Netherlands.
The Netherlands Journal of Medicine
|April 12, 2003
Summary
Long-term use of anthranoid laxatives can cause melanosis coli. This case highlights a potential link between these laxatives and colorectal adenomas, advising caution with their use.
Area of Science:
- Gastroenterology
- Colorectal Medicine
Background:
- Melanosis coli is a known condition associated with long-term use of anthranoid-containing laxatives.
- Anthranoid laxatives are commonly found in over-the-counter products.
Observation:
- A 39-year-old liver transplant patient developed melanosis coli within ten months of using an over-the-counter laxative containing aloe, rheum, and frangula.
- Following discontinuation of the laxative, colonic mucosa returned to normal appearance after one year.
Findings:
- A sessile polypoid lesion, identified as a tubulovillous adenoma with low-grade dysplasia, was discovered in the transverse colon during follow-up colonoscopy.
- This finding aligns with preliminary reports suggesting a potential association between anthranoid laxative use and colorectal adenoma development.
Implications:
- The use of anthranoid-containing laxatives should be discouraged due to potential risks, including colorectal adenoma formation.
- Further research is warranted to elucidate the relationship between anthranoid laxatives and colorectal neoplasia.
- Clinicians should be aware of this potential association when managing patients with a history of laxative use.