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MEDLIB-L  November 2004, Week 4

MEDLIB-L November 2004, Week 4

Subject:

Summary RefQ melanosis coli -- LONG

From:

Guessferd Mary <[log in to unmask]>

Reply-To:

Guessferd Mary <[log in to unmask]>

Date:

Tue, 23 Nov 2004 13:36:49 -0600

Content-Type:

text/plain

Parts/Attachments:

Parts/Attachments

text/plain (97 lines)

I have had requests to summarize responses I received. Here is the
webliography I sent to my doc. It contains most of the web source
suggestions I received from some of you.


Websites with patient level information on melanosis coli:

Diagnosis Health: Constipation page:

 http://www.diagnosishealth.com/constipation.htm
"Stimulant laxatives are frequently used when patients do not respond to
initial measures. Risk for "cathartic colon" has been overblown, and they
are usually safe if taken no more than 2-3 times per week under physician
supervision. Options include senna (Ex-Lax, Senokot), bisacodyl (Dulcolax)
and cascara. Melanosis coli (dark discoloration of colon) may occur due to
prolonged use of certain laxatives, but is harmless. Self-administration of
tap water enema every 3-4 days is helpful for patients not responding to
oral laxatives."

from MedicineNet.com:
http://www.medicinenet.com/script/main/ques.asp?qakey=5710

Question:
What is [melanosis coli]? What does prominent pigmentation within
macrophages of the lamina propria mean? Is this serious? What could develop
later from this ? What do you need to do for this?

Answer:
Melanosis coli is a benign (not serious) condition in which pigmented (black
or brown) material is deposited in the lining of the colon. The condition is
caused by longstanding (chronic) use of certain laxatives (anthraquinones)
that contain cascara or senna. Actually, the pigment is not melanin, as was
originally thought, but rather is a compound called lipofuscin. The
lipofuscin is a product of intestinal cells that died as a result of the
toxic effects of the laxative abuse. The pigment is taken up by scavenger
cells (macrophages) in the lamina propria (the layer just beneath the
lining) of the intestine. Melanosis coli by itself does not cause symptoms
and needs no treatment. In fact, it usually disappears some months or years
after discontinuing the offending laxatives. Moreover, whether melanosis
coli is a risk factor for the development of colorectal polyps or cancer
remains uncertain. On the other hand, it is recommended that the offending
laxatives be discontinued. The reason for this recommendation is that the
melanosis coli is taken as a sign of chronic laxative abuse. And, chronic
laxative abuse can lead to other problems, including the so-called cathartic
colon (abnormal colon function), which can cause constipation and vague
abdominal pains. What's more, chronic laxative abuse can cause diarrhea,
electrolyte abnormalities (e.g., low serum potassium), and weakness.

Jackson Gastroenterology http://www.gicare.com/pated/eicnafmc.htm
423 North 21st Street, Suite 100, Camp Hill, PA 17011. Phone: (717)
761-0930
Fax: (717) 761-0465. Email: [log in to unmask] Web: gicare.com
Copyright 2002 Jackson Gastroenterology. All Rights Reserved.

This site contains several pages of images and references to patient level
information on various gastro diseases and procedures. Contains one page on
melanosis coli:
"Melanosis coli means that a black pigment has infiltrated the colon wall.
It is almost always due to laxatives such as cascara or senna. Melanosis
coli is generally benign but in severe cases it may reduce bowel function
making constipation worse. Image 1 shows a mild case of melanosis coli with
some black speckling across the lining of the colon. In advanced cases as in
Image 2, the inside lining becomes pitch black rather than the normal light
pink."


The Atlas of Gastrointestinal Endoscopy
http://www.endoatlas.com/co_ge_03.html contains several pictures of mucosa
affected by melanosis coli and this text:

"Deposition of dark pigmentation in the colonic mucosa after long-standing
use of anthraquinone-containing laxatives (e.g., phenolphthalein). The
pattern and the degree of pigmentation varies in intestity from patient to
patient, and may vary focally within the same patient (lower right). The
condition is benign and reversible."

Also has a reference page to other "notable sites."

Gastrolab http://www.gastrolab.net/dictw1e.htm
Contains many pages of images and some easily understandable information
about melanosis coli. Includes an Encyclopedia, Image Library, Endoscopy
Archives, Learning Center, Videoclips, Quizzes, Links and Webcasts.

eCureMe.com http://www.ecureme.com/emyhealth/data/Melanosis_Coli.asp
very simple (almost too simplified) description of the condition.




Mimi Guessferd
Medical Librarian/CME Coordinator
Parkland Medical Center
One Parkland Drive
Derry NH 03038-2750
telephone: 603-421-2318
fax: 603-421-2166

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December 2003, Week 5
December 2003, Week 4
December 2003, Week 3
December 2003, Week 2
December 2003, Week 1
November 2003, Week 5
November 2003, Week 4
November 2003, Week 3
November 2003, Week 2
November 2003, Week 1
October 2003, Week 5
October 2003, Week 4
October 2003, Week 3
October 2003, Week 2
October 2003, Week 1
September 2003, Week 5
September 2003, Week 4
September 2003, Week 3
September 2003, Week 2
September 2003, Week 1
August 2003, Week 5
August 2003, Week 4
August 2003, Week 3
August 2003, Week 2
August 2003, Week 1
July 2003, Week 5
July 2003, Week 4
July 2003, Week 3
July 2003, Week 2
July 2003, Week 1
June 2003, Week 5
June 2003, Week 4
June 2003, Week 3
June 2003, Week 2
June 2003, Week 1
May 2003, Week 5
May 2003, Week 4
May 2003, Week 3
May 2003, Week 2
May 2003, Week 1
April 2003, Week 5
April 2003, Week 4
April 2003, Week 3
April 2003, Week 2
April 2003, Week 1
March 2003, Week 5
March 2003, Week 4
March 2003, Week 3
March 2003, Week 2
March 2003, Week 1
February 2003, Week 4
February 2003, Week 3
February 2003, Week 2
February 2003, Week 1
January 2003, Week 5
January 2003, Week 4
January 2003, Week 3
January 2003, Week 2
January 2003, Week 1
December 2002, Week 5
December 2002, Week 4
December 2002, Week 3
December 2002, Week 2
December 2002, Week 1
November 2002, Week 5
November 2002, Week 4
November 2002, Week 3
November 2002, Week 2
November 2002, Week 1
October 2002, Week 5
October 2002, Week 4
October 2002, Week 3
October 2002, Week 2
October 2002, Week 1
September 2002, Week 5
September 2002, Week 4
September 2002, Week 3
September 2002, Week 2
September 2002, Week 1
August 2002, Week 5
August 2002, Week 4
August 2002, Week 3
August 2002, Week 2
August 2002, Week 1
July 2002, Week 5
July 2002, Week 4
July 2002, Week 3
July 2002, Week 2
July 2002, Week 1
June 2002, Week 5
June 2002, Week 4
June 2002, Week 3
June 2002, Week 2
June 2002, Week 1
May 2002, Week 5
May 2002, Week 4
May 2002, Week 3
May 2002, Week 2
May 2002, Week 1
April 2002, Week 5
April 2002, Week 4
April 2002, Week 3
April 2002, Week 2
April 2002, Week 1
March 2002, Week 5
March 2002, Week 4
March 2002, Week 3
March 2002, Week 2
March 2002, Week 1
February 2002, Week 4
February 2002, Week 3
February 2002, Week 2
February 2002, Week 1
January 2002, Week 5
January 2002, Week 4
January 2002, Week 3
January 2002, Week 2
January 2002, Week 1
December 2001, Week 5
December 2001, Week 4
December 2001, Week 3
December 2001, Week 2
December 2001, Week 1
November 2001, Week 5
November 2001, Week 4
November 2001, Week 3
November 2001, Week 2
November 2001, Week 1
October 2001, Week 5
October 2001, Week 4
October 2001, Week 3
October 2001, Week 2
October 2001, Week 1
September 2001, Week 5
September 2001, Week 4
September 2001, Week 3
September 2001, Week 2
September 2001, Week 1
August 2001, Week 5
August 2001, Week 4
August 2001, Week 3
August 2001, Week 2
August 2001, Week 1
July 2001, Week 5
July 2001, Week 4
July 2001, Week 3
July 2001, Week 2
July 2001, Week 1
June 2001, Week 5
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June 2001, Week 3
June 2001, Week 2
June 2001, Week 1
May 2001, Week 5
May 2001, Week 4
May 2001, Week 3
May 2001, Week 2
May 2001, Week 1
April 2001, Week 5
April 2001, Week 4
April 2001, Week 3
April 2001, Week 2
April 2001, Week 1
March 2001, Week 5
March 2001, Week 4
March 2001, Week 3
March 2001, Week 2
March 2001, Week 1
February 2001, Week 4
February 2001, Week 3
February 2001, Week 2
February 2001, Week 1
January 2001, Week 5
January 2001, Week 4
January 2001, Week 3
January 2001, Week 2
January 2001, Week 1
December 2000, Week 5
December 2000, Week 4
December 2000, Week 3
December 2000, Week 2
December 2000, Week 1
November 2000, Week 5
November 2000, Week 4
November 2000, Week 3
November 2000, Week 2
November 2000, Week 1
October 2000, Week 5
October 2000, Week 4
October 2000, Week 3
October 2000, Week 2
October 2000, Week 1
September 2000, Week 5
September 2000, Week 4
September 2000, Week 3
September 2000, Week 2
September 2000, Week 1
August 2000, Week 5
August 2000, Week 4
August 2000, Week 3
August 2000, Week 2
August 2000, Week 1
July 2000, Week 5
July 2000, Week 4
July 2000, Week 3
July 2000, Week 2
July 2000, Week 1
June 2000, Week 5
June 2000, Week 4
June 2000, Week 3
June 2000, Week 2
June 2000, Week 1
May 2000, Week 5
May 2000, Week 4
May 2000, Week 3
May 2000, Week 2
May 2000, Week 1
April 2000, Week 5
April 2000, Week 4
April 2000, Week 3
April 2000, Week 2
April 2000, Week 1
March 2000, Week 5
March 2000, Week 4
March 2000, Week 3
March 2000, Week 2
March 2000, Week 1
February 2000, Week 5
February 2000, Week 4
February 2000, Week 3
February 2000, Week 2
February 2000, Week 1
January 2000, Week 5
January 2000, Week 4
January 2000, Week 3
January 2000, Week 2
January 2000, Week 1
December 1999, Week 5
December 1999, Week 4
December 1999, Week 3
December 1999, Week 2
December 1999, Week 1
November 1999, Week 5
November 1999, Week 4
November 1999, Week 3
November 1999, Week 2
November 1999, Week 1
October 1999, Week 5
October 1999, Week 4
October 1999, Week 3
October 1999, Week 2
October 1999, Week 1
September 1999, Week 5
September 1999, Week 4
September 1999, Week 3
September 1999, Week 2
September 1999, Week 1
August 1999, Week 5
August 1999, Week 4
August 1999, Week 3
August 1999, Week 2
August 1999, Week 1
July 1999, Week 5
July 1999, Week 4
July 1999, Week 3
July 1999, Week 2
July 1999, Week 1
June 1999, Week 5
June 1999, Week 4
June 1999, Week 3
June 1999, Week 2
June 1999, Week 1
May 1999, Week 5
May 1999, Week 4
May 1999, Week 3
May 1999, Week 2
May 1999, Week 1
April 1999, Week 5
April 1999, Week 4
April 1999, Week 3
April 1999, Week 2
April 1999, Week 1
March 1999, Week 5
March 1999, Week 4
March 1999, Week 3
March 1999, Week 2
March 1999, Week 1
February 1999, Week 4
February 1999, Week 3
February 1999, Week 2
February 1999, Week 1
January 1999, Week 5
January 1999, Week 4
January 1999, Week 3
January 1999, Week 2
January 1999, Week 1
December 1998, Week 5
December 1998, Week 4
December 1998, Week 3
December 1998, Week 2
December 1998, Week 1
November 1998, Week 5
November 1998, Week 4
November 1998, Week 3
November 1998, Week 2
November 1998, Week 1
October 1998, Week 5
October 1998, Week 4
October 1998, Week 3
October 1998, Week 2
October 1998, Week 1
September 1998, Week 5
September 1998, Week 4
September 1998, Week 3
September 1998, Week 2
September 1998, Week 1
August 1998, Week 5
August 1998, Week 4
August 1998, Week 3
August 1998, Week 2
August 1998, Week 1
July 1998, Week 5
July 1998, Week 4
July 1998, Week 3
July 1998, Week 2
July 1998, Week 1
June 1998, Week 5
June 1998, Week 4
June 1998, Week 3
June 1998, Week 2
June 1998, Week 1
May 1998, Week 5
May 1998, Week 4
May 1998, Week 3
May 1998, Week 2
May 1998, Week 1
April 1998, Week 5
April 1998, Week 4
April 1998, Week 3
April 1998, Week 2
April 1998, Week 1
March 1998, Week 5
March 1998, Week 4
March 1998, Week 3
March 1998, Week 2
March 1998, Week 1
February 1998, Week 4
February 1998, Week 3
February 1998, Week 2
February 1998, Week 1
January 1998, Week 5
January 1998, Week 4
January 1998, Week 3
January 1998, Week 2
January 1998, Week 1
December 1997, Week 5
December 1997, Week 4
December 1997, Week 3
December 1997, Week 2
December 1997, Week 1
November 1997, Week 5
November 1997, Week 4
November 1997, Week 3
November 1997, Week 2
November 1997, Week 1
October 1997, Week 5
October 1997, Week 4
October 1997, Week 3
October 1997, Week 2
October 1997, Week 1
September 1997, Week 5
September 1997, Week 4
September 1997, Week 3
September 1997, Week 2
September 1997, Week 1
August 1997, Week 5
August 1997, Week 4
August 1997, Week 3
August 1997, Week 2
August 1997, Week 1
July 1997, Week 5
July 1997, Week 4
July 1997, Week 3
July 1997, Week 2
July 1997, Week 1
June 1997, Week 5
June 1997, Week 4
June 1997, Week 3
June 1997, Week 2
June 1997, Week 1
May 1997, Week 5
May 1997, Week 4
May 1997, Week 3
May 1997, Week 2
May 1997, Week 1
April 1997, Week 5
April 1997, Week 4
April 1997, Week 3
April 1997, Week 2
April 1997, Week 1
March 1997, Week 5
March 1997, Week 4
March 1997, Week 3
March 1997, Week 2
March 1997, Week 1
February 1997, Week 4
February 1997, Week 3
February 1997, Week 2
February 1997, Week 1
January 1997, Week 5
January 1997, Week 4
January 1997, Week 3
January 1997, Week 2
January 1997, Week 1
December 1996, Week 5
December 1996, Week 4
December 1996, Week 3
December 1996, Week 2
December 1996, Week 1
November 1996, Week 5
November 1996, Week 4
November 1996, Week 3
November 1996, Week 2
November 1996, Week 1
October 1996, Week 5
October 1996, Week 4
October 1996, Week 3
October 1996, Week 2
October 1996, Week 1
September 1996, Week 5
September 1996, Week 4
September 1996, Week 3
September 1996, Week 2
September 1996, Week 1
August 1996, Week 5
August 1996, Week 4
August 1996, Week 3
August 1996, Week 2
August 1996, Week 1
July 1996, Week 5
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June 1996, Week 5
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May 1996, Week 3
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May 1996, Week 1
April 1996, Week 5
April 1996, Week 4
April 1996, Week 3
April 1996, Week 2
April 1996, Week 1
March 1996, Week 5
March 1996, Week 4
March 1996, Week 3
March 1996, Week 2
March 1996, Week 1
February 1996, Week 5
February 1996, Week 4
February 1996, Week 3
February 1996, Week 2
February 1996, Week 1
January 1996, Week 5
January 1996, Week 4
January 1996, Week 3
January 1996, Week 2
January 1996, Week 1
December 1995, Week 5
December 1995, Week 4
December 1995, Week 3
December 1995, Week 2
December 1995, Week 1
November 1995, Week 5
November 1995, Week 4
November 1995, Week 3
November 1995, Week 2
November 1995, Week 1
October 1995, Week 5
October 1995, Week 4
October 1995, Week 3
October 1995, Week 2
October 1995, Week 1
September 1995, Week 5
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September 1995, Week 2
September 1995, Week 1
August 1995, Week 5
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August 1995, Week 3
August 1995, Week 2
August 1995, Week 1
July 1995, Week 5
July 1995, Week 4
July 1995, Week 3
July 1995, Week 2
July 1995, Week 1
June 1995, Week 5
June 1995, Week 4
June 1995, Week 3
June 1995, Week 2
June 1995, Week 1
May 1995, Week 5
May 1995, Week 4
May 1995, Week 3
May 1995, Week 2
May 1995, Week 1
April 1995, Week 5
April 1995, Week 4
April 1995, Week 3
April 1995, Week 2
April 1995, Week 1
March 1995, Week 5
March 1995, Week 4
March 1995, Week 3
March 1995, Week 2
March 1995, Week 1
February 1995, Week 5
February 1995, Week 4
February 1995, Week 3
February 1995, Week 2
February 1995, Week 1
January 1995, Week 5
January 1995, Week 4
January 1995, Week 3
January 1995, Week 2
January 1995, Week 1
December 1994, Week 5
December 1994, Week 4
December 1994, Week 3
December 1994, Week 2
December 1994, Week 1
November 1994, Week 5
November 1994, Week 4
November 1994, Week 3
November 1994, Week 2
November 1994, Week 1
October 1994, Week 5
October 1994, Week 4
October 1994, Week 3
October 1994, Week 2
October 1994, Week 1
September 1994, Week 5
September 1994, Week 4
September 1994, Week 3
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September 1994, Week 1
August 1994, Week 5
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August 1994, Week 3
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August 1994, Week 1
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July 1994, Week 3
July 1994, Week 2
July 1994, Week 1
June 1994, Week 5
June 1994, Week 4
June 1994, Week 3
June 1994, Week 2
June 1994, Week 1
May 1994, Week 5
May 1994, Week 4
May 1994, Week 3
May 1994, Week 2
May 1994, Week 1
April 1994, Week 5
April 1994, Week 4
April 1994, Week 3
April 1994, Week 2
April 1994, Week 1
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