Changes of colonic mucosa caused by long-term use and discontinuation of anthraquinone

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  • Iwano Eiji
    Kamogata Clinic
  • Iwamuro Masaya
    Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
  • Okada Hiroyuki
    Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences

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  • アントラキノンの長期連用，及び摂取中止が大腸粘膜に与える影響
  • アントラキノン ノ チョウキ レンヨウ,オヨビ セッシュ チュウシ ガ ダイチョウ ネンマク ニ アタエル エイキョウ

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Abstract

Anthraquinone, an anthracene derivatives, is widely used as a purgative medicine. The long-term use of anthraquinone is known to cause melanosis coli and elevated lesions in the colon. However, the clinical course of patients who take anthraquinone over a long term and those who discontinue the drug has not been fully investigated. Here we investigated 22 patients who had colonic mucosal changes (i.e., melanosis coli and elevated lesions) who had been taking anthraquinone for at least one year and discontinued it. We classified the elevated lesions into two subtypes: the small-lesion, which included multiple small nodules that were < 2 mm in dia., and the large-lesion, which included a single or multiple nodules of ≥ 2-mm dia. We used colonoscopy to investigate the changes of colonic lesions between before and after the discontinuation of anthraquinone. The results indicated that the nodules of the small-lesion group were lymphoid follicle hyperplasia. In the large-lesion group, adenoma was most frequently observed (n＝118), followed by hyperplastic polyp (n＝52) and inflammatory changes with edema (n＝22). Melanosis coli and elevated lesions were decreased or invisible after the discontinuation of anthraquinone. Our findings thus suggest that the long-term use of anthraquinone may cause some type of elevated lesions due to chronic inflammation. It is recommended that the use of anthraquinone be limited to a short term.

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