Zhang was constipated for many years, either for many days without feeling, or feel but how can not discharge, so, Zhang began to take a variety of oral laxatives, what fruit guide, senna, Xiang Danqing, intestinal clear tea, detoxification capsules, compound rhubarb granules …… almost every day to eat. As a result, during the colonoscopy doctors saw that his colon was covered with dense black spots, just like leopard prints, and also grew four or five polyps. Auntie Li’s family economic conditions are good, more than three years ago heard people talk about the “magic” effect of clean bowel tea, clean bowel fruit, in order to solve their bowel problems, and incidentally the effect of beauty, she began to eat such health products. But never thought that the recent colonoscopy results are colon melanosis. Now many young people, especially women around 30 years old, they choose the popular so-called “diet tea” to lose weight, which is more or less added to some of the irritating laxatives that have a diuretic and diuretic effect, such as cassia, pan diarrhea leaves, is the cause of the high incidence of colon melanosis in this population. What is colonic melanosis Under normal circumstances, the colonic mucosa is light red under colonoscopy just like the oral mucosa of the oral cavity wall, and it looks smooth and flat, with the texture of small blood vessels on the mucosal surface clearly visible. But when the intestinal mucosa is brown, brown or black-brown in color, and there are gray-white reticulation and stripes on it, like leopard skin, distributed on the colon mucosa piece by piece, and the small blood vessels are blurred or invisible, it is medically known as colonic melanosis. It is a benign, non-inflammatory, reversible lesion with an incidence of 0.06% to 5.9%, and is a mucosal pigmented lesion containing lipofuscin-like material in macrophages in the lamina propria of the colonic mucosa. Causes of colonic melanosis The cause of colonic melanosis is not fully understood, but most physicians believe that the disease is closely related to the long-term use of laxatives by patients to address chronic constipation. The main causes are as follows. 1, anthraquinone laxatives: frequent use of laxatives is the main factor of colonic melanosis, and anthraquinone laxatives are the most common drugs that cause this disease. Anthraquinone laxatives mainly include Chinese herbal medicines such as rhubarb, aloe vera, senna, or nux vomica antidote tablets, hemp seeds and intestinal pills, fruit guide tablets, aloe vera capsules, as well as adult medicines made of aloe vera, rhubarb, senna, boswellia bark, phenolphthalein and other extracts. Anthraquinones are present not only in drugs such as rhubarb and maitake with laxative effect, but also in other species of herbal drugs, such as Astragalus and He Shou Wu. And the level of free anthraquinone compounds in the drugs determines the black edge of colonic melanosis and the degree of damage. Foreign studies have concluded that such laxatives can induce the destruction of the intestinal mucosal barrier and promote the release of tumor necrosis factor, which leads to apoptosis of colonic epithelial cells, phagocytosis by macrophages and the formation of brown pigment in the lamina propria of the colon taking the opportunity to develop colonic melanosis. 2, chronic constipation: long-term constipation patients who have not taken laxatives can also develop colon melanosis, probably because of the long accumulation of feces in the intestine, intestinal absorption of bacterial synthesis of pigment particles leading to colon melanosis. 3, metal elements and minerals: In recent years, it is believed that colonic melanosis may be related to the intake of trace metal elements or minerals such as iron, magnesium, silicates, calcium, palladium, zinc ore, lead, cadmium, nickel and manganese. 4, other: some chronic inflammatory bowel disease and ulcerative colitis and chronic diarrhea may also be factors leading to colonic melanosis. How to confirm the diagnosis of colonic melanosis With the change of people’s diet and lifestyle, the acceleration of aging, the increase in the incidence of constipation and the popularity of electronic colonoscopy, the detection rate of colonic melanosis is increasing and is receiving more and more attention. 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. The diagnosis of colonic melanosis mainly relies on colonoscopy and pathological examination. Colonoscopy usually reveals a marked darkening of the intestinal lumen and a smooth and intact colonic mucosa with light brown, tan or black pigmentation. The pigmentation may be streaked, patchy, or tiger skin-like, forming a network of intermittent or continuous distribution. In some cases, white or pink polyp elevations are seen. The lesions are mostly confined to the proximal colon, such as the left hemicolon, transverse colon, or in severe cases, the whole colon. Based on the results of colonoscopy, the clinical diagnosis is not very difficult. Can colonic melanosis become cancerous? Whether colonic melanosis is cancerous or not is the most important question people are concerned about. Currently, most scholars believe that colorectal cancer is not related to colonic melanosis. Some studies have also shown that the probability of colon adenoma and colon cancer among patients with colonic melanosis is higher than that of patients with non-colonic melanosis, which is probably due to the fact that patients with colonic melanosis suffer from long-term constipation, resulting in prolonged retention of pathogenic substances in the intestine and repeated stimulation of intestinal mucosal epithelial proliferation, which may lead to adenoma or cancer. When endoscopy is performed, polyps or adenomas next to the blackened mucosa are found to be uncolored, and small adenomas in the background of the blackened mucosa are more easily detected. Therefore, regular colonoscopy is a better cancer prevention option for patients with colonic melanosis. The pigmented spots in the colonic mucosa can gradually fade with the discontinuation of laxatives. Therefore, avoiding laxative abuse is the key to the prevention and treatment of colonic melanosis. Literature reports show that colonic melanosis often occurs within 5 months of taking anthraquinone laxatives and reverses after 6-12 months of discontinuing laxatives. Therefore, the relevant anthraquinone laxatives should be discontinued in a timely manner, and comprehensive therapeutic measures should be given to those who are constipated, and pro-intestinal motility drugs and non-anthraquinone laxatives should be used to laxate as much as possible. For those who are prone to constipation, especially women and the elderly, they should actively and effectively deal with constipation to prevent the occurrence of colonic melanosis. First, develop good bowel habits, and focus on the phone or other things during bowel movements. Second, consume more dietary fiber-rich foods such as bran or brown rice, vegetables such as celery and leeks, and increase water intake to enhance the stimulation of the colon. Increase the amount of exercise, if there is really no time, you can do more half squats in the office, you can also exercise the abdominal muscle tone to make up for the lack of exercise. At the same time, pay attention to the regulation of their emotional and psychological state, an occasional constipation do not have a psychological burden.