Laxative Abuse and The Colon

The New England Journal of Medicine showed this appearance of the inside walls of a colon found on colonoscopy. The answer to the image challenge, of course, is laxative use. (click on the photo to see up close). The 2nd image shows the appearance of a normal colon. Note the pink skin and the normal folds which are quite different in appearance than the first image.

Laxative abuse causes a condition called Melanosis coli. It causes a dark brown pigmentation that occurs with laxatives containing anthraquinone, such as senna. After a few months of use it is seen and it will disappear when the laxative is discontinued.

Laxatives should only be used for short periods of time. Chronic constipation is a problem for many people. After a visit to the doctor to rule out motility disorder, thyroid disorder or other medical problems, most constipation can be resolved with increased fiber, fluids and exercise. Abdominal massage and relaxation techniques also help to restore good bowel health.

Colonics are never needed for the bowel, which does not build up "toxins" nor are powerful enemas needed for good health.


Cary said…
So I guess laxatives as a dieting tool is a bad idea? On to Plan B: binging and purging.
KM said…
I wonder if this person is bulimic? Do you have a photo of a bulimic persons esophagus from endoscopy also?
Toni Brayer MD said…
Cary: hahaha

KM: A bulimic's esophagus might have erosions from stomach acid. Often people with bulimia have loss of enamel on teeth from acid also.
tracy said…
And Cary Funny-Not.
This is important because I didn't know that Laxative abuse causes a condition called Melanosis coli, actually I've heard if we do that frequently we might have serious colon conditions and the excrement can come like a liquid fluid.m110m
sildenafil said…
On biopsy, melanosis coli shows characteristic pigment-laden macrophages within the mucosa on PAS staining. The histologic differential diagnosis of mucosal pigmentation is: lipofuscin (melanosis coli), hemosiderin-laden macrophages, and melanin (rare). said…
What namely you are writing is a horrible mistake.

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