A case of colonic melanosis in a patient on long-term dialysis that was improved by the administration of lubiprostone

Abstract

We experienced a case in which the colonic melanosis of a patient on long-term dialysis was improved by the administration of lubiprostone. The patient was a 79-year-old male who was receiving 24 mg of sennoside daily (a single oral dose) for constipation. As the patient’s defecation control remained poor, he underwent colonoscopy to exclude organic disease. On colonoscopy, no stenotic lesions, such as colon cancer, were found, but melanosis was identified throughout the entire colon. The administration of sennoside was discontinued, and the oral administration of lubiprostone was started, after which the patient’s defecation control improved. As patients on dialysis have a high prevalence of constipation, anthraquinone-based drugs, such as sennoside, are frequently used. However, the long-term use of anthraquinones carries a risk of melanosis coli, which can in turn be a risk factor for colon adenoma and colon cancer. The administration of lubiprostone to dialysis patients with colon melanosis might improve their constipation and colon melanosis.