Anthranoid self-medication causing rapid development of melanosis coli.
It is widely known that long-term use of anthranoid-containing laxatives is the cause of melanosis coli. We describe a case of melanosis coli, which occurred in a 39-year-old liver transplant patient who took an over-the-counter product containing aloe, rheum and frangula. The typical brownish pigmentation of the colonic mucosa developed in a period of ten months. The anthranoid medication was stopped and follow-up colonoscopy one year later showed normal looking mucosa once more. However, in contrast to previous examinations, a sessile polypoid lesion was found in the transverse colon. Histology showed tubulovillous adenoma with extensive low-grade dysplasia. Since there have been preliminary reports suggesting a possible role of anthranoid-containing laxatives in the development of colorectal adenomas and cancer, their use should be discouraged.
Willems
M
M
Department of Gastroenterology and Hepatology (Ca 415), Erasmus Medical Centre, PO Box 2040, 3000 CA Rotterdam, The Netherlands.
van Buuren
H R
HR
de Krijger
R
R
D000328:Adult; D000880:Anthraquinones / Q000009:adverse effects*; D002400:Cathartics / Q000009:adverse effects*; D003108:Colonic Diseases / Q000139:chemically induced* / Q000473:pathology; D006801:Humans; D008297:Male; D008548:Melanosis / Q000139:chemically induced* / Q000473:pathology; D012651:Self Medication / Q000009:adverse effects*; D013997:Time Factors
D000880:Anthraquinones; D002400:Cathartics