With the general acceptance of colonoscopy, many intestinal diseases are gradually understood, for example, colonic melanosis, etc. But how dangerous is this disease wearing tiger spots? How does it occur? Is it curable? Today, I’d like to give you a good explanation of colon melanosis. What is colon melanosis? Colon melanosis is a non-inflammatory intestinal disease caused by melanin deposition, the essence of which is the presence of large amounts of lipofuscin in macrophages in the lamina propria of the colon mucosa. It is more common in men than in women, and the age of onset is more than 60 years. The main symptoms are abdominal distension, constipation and difficulty in defecation, while a few patients have vague pain in the lower abdomen and poor appetite. What are the causes of colonic melanosis? It is not hereditary and is common in the elderly. The exact cause is still unknown. The essence of colonic melanosis is that macrophages in the lamina propria of the colon mucosa contain a large amount of lipofuscin, which has been reported more frequently abroad and less frequently in China. As early as 1928, Banle proposed the relationship between colonic melanosis and anthraquinone laxatives (73%), and long-term oral laxatives are recognized by most scholars as the main cause of colonic melanosis, especially anthraquinone drugs (Melissa bark, senna leaf, rhubarb soda, etc.), and oral administration is based on oxaliplatin tablets, hemp seed laxative pills, aloe vera. The shortest period of time for the occurrence of colonic melanosis is reported to be 4 months in foreign countries and 1 month in China for those who take laxatives, and 23.0% for those who take less than 4 months. The incidence of colonic melanosis was 9.52% in patients who took medication intermittently for less than 1 year, 11.25% in those who took medication intermittently for more than 1 year, and 77.78% in those who took medication continuously for less than 1 year; the incidence was as high as 81.06% in those who took medication continuously for more than 1 year. What are the clinical manifestations of colonic melanosis? There are no specific symptoms and signs of colonic melanosis, mainly abdominal distension, constipation and difficulty in defecation, and a few patients have vague pain in the lower abdomen and poor appetite. Some patients have low blood potassium, low blood sodium and low blood calcium. Occasionally, edematous colonic stenosis is seen. It is more often associated with colon cancer, adenoma and polyps. What are the tests for colonic melanosis? 1.Laboratory tests Routine blood tests show normal, but a small number of patients may have sodium, potassium and calcium deficiency. 2.Colonoscopy The endoscopic manifestation of colonic melanosis is that the colonic mucosa is smooth and intact, with light brown, tan or black pigmentation in the form of streaks, patches or tiger skin changes, which can be networked intermittently or continuously, and the intestinal lumen is obviously darkened. It may be accompanied by white or pink polyp bulges, and in some cases the mucosa is not significantly pigmented, while biopsy of polyps in the sigmoid colon unexpectedly confirms colonic melanosis. What is the grade of colonic melanosis? 1.Grade I Light black, similar to leopard skin, the mucosal vascular texture is faintly visible, the lesion is more limited, and the demarcation with the surrounding normal mucosa is not very clear. 2, Ⅱ degree dark black-brown, there are lines of milky white mucosa between the dark black-brown mucosa, mostly seen in the left half of the colon or a section of the colon mucosa, mucosal vessels are not clear, and there is a clear demarcation with the normal mucosa. 3, Ⅲ degree dark brown-black, dark brown-black mucosa with small milky white lines or spots of mucosa, submucosal blood vessels can not be seen, this performance is more common in the entire colon. In terms of the location of the lesion, if the lesion is more common in the proximal colon, it can be performed in the entire colon. Pathological diagnosis of colonic melanosis? It is mainly based on the presence of varying degrees of pigmentation in the intestinal mucosa on colonoscopy, and pathological histological examination reveals a large number of macrophages containing pigment granules in the lamina propria of the mucosa, positive melanin staining, and negative iron staining. Clinical manifestations cannot be used as a basis for diagnosis. Treatment of colonic melanosis? There is no specific treatment for colonic melanosis, and the symptoms may improve after stopping the above-mentioned laxatives. There is no specific drug treatment for colonic melanosis. Most scholars believe that colonic melanosis is a benign and reversible non-inflammatory intestinal mucosal lesion. With the improvement of constipation symptoms and the discontinuation of laxatives, a large amount of lipofuscin is digested and decomposed by lysosomes, and the pigmentation of colonic melanosis can be reduced or even disappeared. For some possible causes of melanosis such as rectal protrusion and endorectal sleeve, treatment should be given, such as rectal protrusion repair and endorectal sleeve homotomy. For patients who have been diagnosed with colonic melanosis, regular follow-up colonoscopy should be performed to detect the accompanying colon polyps, adenomas and colon cancer in time for early endoscopic treatment with high-frequency electrosurgery or surgical eradication. However, for those who have this disease without a history of taking laxatives, the treatment method is yet to be further explored.