A 43-year-old woman came to the clinic with left-sided abdominal pain, fullness, alternating diarrhea and constipation with anal cramping, incomplete bowel movements, weakness and fatigue for six months. The patient came to the clinic with pain and constipation on the left side of the abdomen alternating with anal cramps, bowel movements, weakness, dullness, and fatigue. As soon as the patient returned to the clinic, he asked: “The doctor said my intestines are black, what is the cause of this? Can it be cured? Will it become cancerous?” . The author had to comfort the patient while pursuing the medical history. It turns out that this patient has a history of habitual constipation for more than ten years, the stool does not go down with senna leaves in water as a tea drink, recently just constipation when taking. I then told the patient, your intestines become black is long serving senna “trouble”. So, what is colon blackening? What can be done to prevent it? Qinghai Provincial Hospital of Traditional Chinese Medicine, Department of Gastroenterology, Fuxinshun Colonic melanosis (MC) is an intestinal disease characterized by pigmentation of the colonic mucosa, which is non-inflammatory, benign and reversible. It is clinically characterized by constipation, diarrhea, abdominal pain, bloating, and anal cramping. Current studies mostly suggest that MC is associated with chronic constipation while taking laxatives, especially with the abuse of stimulant anthraquinone-based laxatives. In addition, oral administration of laxatives made from extracts of senna leaf, rhubarb or aloe vera containing anthraquinones, which are claimed to be “detoxifying” and “laxative”, as well as diphenylmethane laxatives, can also lead to MC. volumetric laxatives (e.g. magnesium sulfate, etc.) are not suitable for those with slow bowel movements. (not suitable for patients with sluggish bowel movements), stimulant laxatives (e.g., chloroform, castor oil, rhubarb, senna, etc., used for stool impaction and those who need rapid laxation, not suitable for long-term application), lubricating laxatives (e.g., liquid paraffin, etc.), osmotic laxatives (e.g., lactulose), prokinetic agents (e.g., mosapride, etc.), and 5-HT4 agonists (e.g., tegaserod, polyethylene glycol, etc.). (e.g., tegaserod, polyethylene glycol, etc.). Some patients with chronic inflammatory bowel disease can also suffer from MC even without the use of laxatives, and clinical observations have shown that taking stimulant anthraquinone-based laxatives for 1-4 months can cause damage to the colonic epithelium and phagocytosis by phagocytes in the lamina propria, and the pigments in the cytoplasm of these phagocytes can darken the colonic mucosa. Electron colonoscopy reveals a black, brown or dark gray colonic mucosa with yellow or pink margins or early lesions that are tiger skin patterned, betel nut cut like or patchy. Pathological histological examination shows a large number of dense or scattered macrophages in the lamina propria, and the cytoplasm is filled with black granules. the incidence of colonic polyps is higher in MC patients than in the normal population, and colonic polyps are a definite precancerous lesion. Although there is no specific pharmacological treatment for MC, the pigmented spots of MC can diminish or even disappear completely with the discontinuation of laxatives. Therefore, in addition to preventing the abuse of anthraquinone-based laxatives, the key to the prevention and treatment of MC is the proper treatment of constipation, and patients who have MC without a history of taking laxatives should also look for the cause. Patients who have been diagnosed with MC should be reviewed regularly for colonoscopy. If there are complications of colon polyps, high-frequency electrosurgery and biopsy should be performed under colonoscopy. If the diagnosis of colon cancer is confirmed, surgery should be performed promptly for radical treatment. Therefore, I advise those who love “beauty” ladies and gentlemen who want to “handsome”, do not blindly abuse “detoxification”, “laxative weight loss “of drugs, but should put their hopes on diet, exercise. For patients with constipation, should do: ① eat more vegetables, especially vegetables with high fiber content, such as radish, celery, Chinese cabbage, leek, spinach, white fungus, garlic, soybean sprouts, etc.; ② if there are no special contraindications (such as coronary heart disease, arteriosclerosis, biliary tract disorders, etc.), can eat more oily food; ③ eat more coarse grains (such as corn, etc.), less fine grains (such as rice, wheat, etc.); ④ eat more cucumbers, bananas, pears (5) once a day, squat in the toilet regularly to adjust the biological clock and develop conditioned reflexes; (6) drugs can be used to nourish yin and increase fluid, lubricate the intestines, and guide the qi downward with Chinese herbs such as fire hemp seed, Yu Li Ren, Angelica sinensis, Cistanches, Rhizoma Atractylodis Macrocephalae, Citrus aurantium, Radix et Rhizoma, Radix et Rhizoma Macrocephalae, etc. (7) Western medicine can be used in the short term as volumetric laxatives, lubricating laxatives, osmotic slow laxatives, prokinetic drugs and 5-HT4 agonists. ⑧ Ideas luck method to assist defecation, that is, when the solution can not solve the stool, to focus on the exclusion of distracting thoughts, the tip of the tongue against the palate, the nose calmly and naturally inhale, open the mouth deep, long, slow, light exhale, while thinking of the gas to the small abdomen, to reach the rectum, straight push the stool in the intestine, so constantly thinking of the exhaled gas to push the stool down, after a few minutes, the stool can be discharged. ⑨ abdominal massage helps to increase the tension of the intestinal wall, which is vital to the long-term prevention and treatment of habitual constipation. Can take a sitting or standing position, the palm of the right hand on the umbilicus, the left palm on the back of the right hand, in the small abdomen clockwise slowly and gently massage 25 times, and then 25 times in the counterclockwise direction, a total of 50 times, every morning and evening once a day, for 2 to 4 weeks.