대한대장항문학회

Purpose : Melanosis coli, which is a relatively common disease encountered during<br>colonoscopy, is a brownish or blackish pigmentation of the colon and is associated with the<br>ingestion of anthraquinone compounds. Its histopathological pathogenesis is recognized as<br>colonic epithelial apoptosis. This study was designed to identify the relation between<br>melanosis coli and the colonic transit time, as well as the relation between melanosis coli and<br>other clinical characteristics. Methods : We reviewed the clinical records of 80 patients with<br>melanosis coli who had been diagnosed by colonoscopy between Jan. 1997 and Sep. 1998. The<br>colonic transit time was checked in 26 cases of patients with melanosis coli and in 28 cases<br>of patients with constipation without melanosis coli by using the multiple marker bolus<br>technique. Results : 1) The frequency of melanosis coli in patients undergoing a total<br>colonoscopy was 1.25% (80/6422). 2) The age distribution was 20 to 76 years old (mean: 49).<br>The grade of melanosis coli seemed to be related with age. 3) The four causative agents<br>related with melanosis coli were anthraquinone compounds (69.2%), tea (12.3%), herbs<br>(12.3%) and health foods in that order. 4) The duration of medication was from 2 months to<br>20 years (mean: 48 months). The grade of melanosis coli seemed to be related with the<br>duration of medication. 5) The colonic transit time was normal in 11 cases (42.3%) and<br>delayed in 15 cases (57.5%) of melanosis coli and normal in 10 cases (35.7%) and delayed in<br>18 cases (64.3%) of patients with constipation without melanosis coli. 6) Colon polyps were<br>detected in 12 cases (15%). However, no relation between the incidence of colon polyps and<br>either the grade of melanosis coli or the duration of medication was noted. Conclusions :<br>Melanosis coli is a marker of ingestion of some drugs, such as anthraquinone compounds,<br>and/or some kinds of acidic polysaccharides. Melanosis coli is not an indicator of colonic<br>motility disorder or a danger signal for colon polyps or cancer.<br>