# Melanosis



## 20417 (Oct 25, 2006)

Does anyone know what can cause melanosis in a person who has not used laxatives (except for colonoscopy prep)? It is my understanding that most cases of melanosis coli are caused by overuse of laxatives, and that the condition can self-correct if laxatives are discontinued.Can this condition self-correct in someone who wasn't using laxatives in the first place?


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## Kathleen M. (Nov 16, 1999)

This is about the only thing I found that was a reason to have it in the appendix that was not about laxative use: http://www.blackwell-synergy.com/doi/abs/1...59.2001.01205.x I don't know if there is any evidence for this being more generalized.It is usualy considered to be benign so I don't know if they have looked at it that closely.They do put senna and cascara in a lot of dieter's teas and colon cleansers and other herbal mixes so someone could be taking the herbs that cause it but not be taking something called a laxative.K.


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## Kathleen M. (Nov 16, 1999)

PS did they take any biopsies to check to see if there was anything else going on that could account for the coloration?K.


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## 20417 (Oct 25, 2006)

Thanks, Kathleen. Yes, they did a biopsy that found inflammation. The doctor said this was not caused by the prep. He said it is a case of "monitor closely". I was hoping for a 10-year recall for the colonoscopy, so no luck there! They were suspicious of IBD, which was the reason for the colonoscopy.They also found several diverticuli, plus a floppy colon.I am iron deficient, and had taken about 10 iron tablets prior to the colonoscopy. I stopped taking the iron two weeks before the colonoscopy (instead of the usual 10 days). They were aware of the iron supplementation. I don't think it could cause melanosis so quickly?Could a family history of malignant melanoma in any way be related?


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## Kathleen M. (Nov 16, 1999)

Not that I know of.I think the coloration is not really melanin, but the laxative or it's metabolites being taken up by the "clean up" cells of the immune system in the colon.Now inflamation could bring those cells to the colon, but I'm not sure why they would be colored. However that appendix paper did mention apoptosis (programmed cell death) and that can be a part of inflamation. I think the appendix studies were in people who were having it removed and that usually means infection/inflamation. They were looking at kids so long-term laxative use wasn't really a big issue with that population.But you would think if this were common you would see it in a lot of IBDers and it wouldn't be such an unusual finding.I'll take another google around and report back.K.


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## Kathleen M. (Nov 16, 1999)

Well I found This paperThey looked at the coloration issue in IBD patients who presented with it. Only 20% of them had been using laxatives.So it could be the apoptosis thing with that sort of inflamation, like you saw with inflamation in the appendix removal patients.Hope this helpsK.


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## 20417 (Oct 25, 2006)

No one has called it IBD yet, but it seems to me that IBD is still very much on the table. I guess time will tell.


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## Kathleen M. (Nov 16, 1999)

There isn't a whole lot out there on non-IBD inflamation of the colon, and they did see inflamation so that was the reason to look at the IBD stuff.Inflamation is pretty much the same no matter what the actual cause of it is, so if an IBD could cause this without laxatives then I'd suspece other causes for inflamation could cause this without laxatives.K.


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## 20417 (Oct 25, 2006)

Here's an article on apoptic counts being used to determine if this is drug-induced or not. It's over my head, but anyways...I know that laxatives are not the cause.


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## 20417 (Oct 25, 2006)

http://www.pubmedcentral.nih.gov/articlere...gi?artid=501141


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