Jump to ContentJump to Main Navigation
Show Summary Details
More options …

Open Medicine

formerly Central European Journal of Medicine

Editor-in-Chief: Darzynkiewicz, Zbigniew


IMPACT FACTOR 2018: 1.221

CiteScore 2018: 1.01

SCImago Journal Rank (SJR) 2018: 0.329
Source Normalized Impact per Paper (SNIP) 2018: 0.479

ICV 2017: 152.94

Open Access
Online
ISSN
2391-5463
See all formats and pricing
More options …
Volume 5, Issue 3

Issues

Volume 10 (2015)

Herbal remedies are the main etiologic factor in melanosis coli, a case series study

Taylan Kav / Yusuf Bayraktar
Published Online: 2010-04-09 | DOI: https://doi.org/10.2478/s11536-009-0121-7

Abstract

Melanosis coli is a brown to black discoloration of the colon mucosa usually associated with long-term ingestion of laxatives. However, melanosis coli can be found in patients with no history of laxative use. Regular use of herbal remedies could be the major source of anthranoid laxatives in such patients. We designed a prospective case series study to identify the clinical characteristics and etiology of melanosis coli in affected patients. This study took place in Ankara, Turkey, between 08/2005 and 11/2006. Patients with endoscopic diagnosis of melanosis coli were interviewed for demographical data and use of herbal remedies. A total of 380 colonoscopies were performed during this period. Melanosis coli was diagnosed endoscopically in 12 patients (3.17%), 11 of whom were found to have characteristic pigment-laden macrophages in histopathological examination. Herbal remedies were the main etiological factor in the development of melanosis coli in 10 out of 11 patients. Diffuse involvement was found in 2 patients who had a history of long-term use. In 8 patients, melanosis coli was located in the left side of the colon. Although melanosis coli is a harmless discoloration of colonic mucosa resulting from complementary or alternative medicine, we believe that this association with herbals was overlooked or not inquired in patients. Therefore, it should be emphasized that “natural” or “alternative” is not equal to “safe”.

Keywords: Melanosis coli; Herbal remedies; Laxatives; Sennosides; Etiology

  • [1] Muller-Lissner SA Adverse Effects Of Laxatives: Fact And Fiction Pharmacology 1993 Oct;47 Suppl 1:138–45 Google Scholar

  • [2] Nusko G, Schneider B, Schneider I, Wittekind CH, Hahn E G Anthranoid Laxative Use Is Not A Risk Factor For Colorectal Neoplasia: Results Of A Prospective Case Control Study Gut 2000;46:651–655 CrossrefGoogle Scholar

  • [3] Wald A Is Chronic Use Of Stimulant Laxatives Harmful To The Colon? J Clin Gastroenterol 2003;36(5):386–389 http://dx.doi.org/10.1097/00004836-200305000-00004CrossrefGoogle Scholar

  • [4] Tillisch K Complementary And Alternative Medicine For Functional Gastrointestinal Disorders Gut 2006;55:593–596 http://dx.doi.org/10.1136/gut.2005.078089CrossrefGoogle Scholar

  • [5] Comar KM., Kirby DF Herbal Remedies In Gastroenterology J Clin Gastroenterol 2005;39:457–468 http://dx.doi.org/10.1097/01.mcg.0000165650.09500.3aCrossrefGoogle Scholar

  • [6] Ernst E Complementary Medicine In Gastroenterology: More Than A Fad? J Clin Gastroenterol, Vol 36, No. 5,P:453 Google Scholar

  • [7] Kong SC, Hurlstone DP, Pocock CY, Walkington LA, Farguharson NR, Bramble MG, McAlindon ME, Sanders DS. The Incidence Of Self-Prescribed Oral Complementary And Alternative Medicine Use By Patients With Gastrointestinal Diseases J Clin Gastroenterol 2005;39:138–141 http://dx.doi.org/10.1097/01.mcg.0000155570.19340.61CrossrefGoogle Scholar

  • [8] Saracoglu A, Ergun B Composition Of Some Herbal Slimming Tea Preparations Marketed In Turkey And Their Possible Adverse Effects Turkiye Klinikleri J Med Sci 2006, 26:355–363 Google Scholar

  • [9] Park WK, Cho KA, Hwang DY Clinical Review Of Melanosis Coli. J Korean Soc Coloproctol. 1999 Aug; 15(3):187–193. Korean Google Scholar

  • [10] Ghadially FN, Walley VM Melanoses of the Gastrointestinal Tract Histopathology 1994, 25. 197–207 http://dx.doi.org/10.1111/j.1365-2559.1994.tb01319.xCrossrefGoogle Scholar

  • [11] De Witte P, Metabolism And Pharmacokinetics Of Antrhanoids, Pharmacology 1993; 47(Supplement 1): 86–97 http://dx.doi.org/10.1159/000139847CrossrefGoogle Scholar

  • [12] Van Gorkom BA, De Vries EG, Karrenbeld A, Kleibeuker JH. Review Article: Anthranoid Laxatives And Their Potential Carcinogenic Effects. Aliment Pharmacol Ther 1999;13(4):443–52 http://dx.doi.org/10.1046/j.1365-2036.1999.00468.xCrossrefGoogle Scholar

  • [13] Wang X, Zhong YX, Lan M, Zhang ZY, Shi YQ, Lu J, Ding J, Wu KC, Jin JP, Pan BR, Fan DM. Screening And Identification Of Proteins Mediating Senna Induced Gastrointestinal Motility Enhancement In Mouse Colon World J Gastroenterol 2002;8(1):162–167 Google Scholar

  • [14] Folium Sennae, In WHO Monographs On Selected Medicinal Plants Vol. 1 Geneva 1999, Pp: 241–250 Google Scholar

  • [15] Tillisch K Complementary and Alternative Medicine for Gastrointestinal Disorders Clin Med 2007;7(3):224–7 CrossrefPubMedGoogle Scholar

  • [16] Langmead L, Rampton DS Review article: complementary and alternative therapies for inflammatory bowel disease Aliment Pharmacol Ther 2006 1; 23 (3) 341–349 http://dx.doi.org/10.1111/j.1365-2036.2006.02761.xCrossrefGoogle Scholar

  • [17] Van Tilburg MA, Palsson OS, Levy RL, Feld AD, Turner MJ, Drossman DA, Whitehead WE. Complementary And Alternative Medicine Use And Cost In Functional Bowel Disorders: A Six Month Prospective Study In A Large HMO BMC Complement Altern Med 2008 Jul 24; 8:46 http://dx.doi.org/10.1186/1472-6882-8-46CrossrefGoogle Scholar

  • [18] Pardi DS, Tremaine WJ, Rothenberg HJ, Batts KP. Melanosis Coli In Inflammatory Bowel Disease. J Clin Gastroenterol 1998;26:167–170 http://dx.doi.org/10.1097/00004836-199804000-00003CrossrefGoogle Scholar

  • [19] Von Gorkom BA, Karrenbeld A, Van Der Sluis T, Zwart N, de Vries EG, Kleibeuker JH. Apoptosis Induction By Sennoside Laxatives In Man; Escape From A Protective Mechanism During Chronic Sennoside Use? J Pathol 2001;194:493–499 http://dx.doi.org/10.1002/path.914CrossrefGoogle Scholar

  • [20] Nusko G, Schneider B, Muller G, Kusche J, Hahn EG. Retrospective Study On Laxative Use And Melanosis Coli As Risk Factors For Colorectal Neoplasma. Pharmacology 1993;47Supl 1:234–241 http://dx.doi.org/10.1159/000139863CrossrefGoogle Scholar

  • [21] Nusko G, Schneider B, Ernst H, Wittekind C, Hahn EG. Melanosis Coli — A Harmless Pigmentation Or A Precancerous Condition? Z Gastroenterol 1997;35:313–318 Google Scholar

About the article

Published Online: 2010-04-09

Published in Print: 2010-06-01


Citation Information: Open Medicine, Volume 5, Issue 3, Pages 347–353, ISSN (Online) 2391-5463, DOI: https://doi.org/10.2478/s11536-009-0121-7.

Export Citation

© 2010 Versita Warsaw. This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License. BY-NC-ND 3.0

Citing Articles

Here you can find all Crossref-listed publications in which this article is cited. If you would like to receive automatic email messages as soon as this article is cited in other publications, simply activate the “Citation Alert” on the top of this page.

[1]
Jiefeng Chen, Shaodong Li, Mengping Liu, Christopher Wai Kei Lam, Zheng Li, Xinjun Xu, Zuanguang Chen, Wei Zhang, and Meicun Yao
Frontiers in Pharmacology, 2017, Volume 8

Comments (0)

Please log in or register to comment.
Log in