严重的结肠黑变病结肠镜检查

Colonoscopy of Severe Melanosis Coli


Melanosis coli is a brownish discoloration of the colon mucosa, caused by the accumulation of pigment in macrophages within the lamina propria.

Animal and human studies have shown an association between m.
coli and the chronic use of anthraquinone laxatives, such as cascara
sagrada, aloe, senna, rhubarb, and frangula.3,4 The discoloration often
appears within 4 months of use and is observed in up to 70% of chronic
users of implicated laxatives. The condition is widely regarded as benign and reversible, and the pigment generally disappears within 1 year of stopping laxatives.
Earlier concerns about a possible relationship between
m. coli and the development of colonic neoplasia have not been substantiated in prospective studies.
Melanosis coli has been associated
with the chronic use of anthroquinone laxatives. These include several plants, such as aloe, cascara, and senna. Aloe plants are members of the lily family, of which the aloe vera plant is the most common. Cascara sagrada is the common name of the
California buckthorn (Rhamnus purshianus), a shrub that grows in
the Pacific Northwest. The bark of the cascara sagrada shrub and juice
from the leaves of aloe plants have been used for medicinal purposes.
Folk medicine has historically used both as laxatives.

On November 5, 2002, the U.S. Food and Drug Administration (FDA) issued a final ruling stating that aloe and cascara sagrada cannot be labeled or sold as stimulant
laxatives in over-the-counter (OTC) drug products due to a lack of research on safety and efficacy.

All OTC medications containing these ingredients have not been available since then. Research about the efficacy and safety of senna was submitted to the FDA, and sennacontaining products were allowed to stay in the OTC category.
Herbal supplements are regulated by the FDA under the category of dietary supplements. The regulations covering these are different from
those covering conventional foods and drug products (both prescription and OTC). Under the Dietary Supplement Health and Education
Melanosis coli has been associated
with the chronic use of anthroquinone laxatives. These include several plants, such as aloe, cascara, and senna. Aloe plants are members of the lily family, of which the aloe vera plant is the most common. Cascara sagrada is the common name of the
California buckthorn (Rhamnus purshianus), a shrub that grows in
the Pacific Northwest. The bark of the cascara sagrada shrub and juice
from the leaves of aloe plants have been used for medicinal purposes.
Folk medicine has historically used both as laxatives. On November 5, 2002, the U.S.
Food and Drug Administration (FDA) issued a final ruling stating
that aloe and cascara sagrada cannot be labeled or sold as stimulant
laxatives in over-the-counter (OTC) drug products due to a lack of research on safety and efficacy
All OTC medications containing these ingredients have not been available since then. Research about the efficacy and safety of senna was submitted to the FDA, and sennacontaining products were allowed to stay in the OTC category.
Herbal supplements are regulated by the FDA under the category of dietary supplements. The regulations covering these are different from
those covering conventional foods and drug products (both prescription and OTC). Under the Dietary Supplement Health and Education.
illustrates the risk associated with the current situation
in the U.S., where medications extracted from plants might not be
allowed to be marketed as medications; however, they can be widely
sold as dietary supplements while
keeping all their medicinal properties and AEs. The authors strongly
encourage patients to be aware of these potential risks