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Melanosis Coli Is Not Associated with Colonic Dysmotility Nor Severity of Pediatric Functional Constipation

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Abstract

Background

Sennosides are commonly used for the treatment of constipation and associated with melanosis coli. In the present study, we evaluated the utility of melanosis coli as a marker of severity and its association with colonic motility in children with functional constipation.

Methods

Prospective study includes pediatric patients undergoing colonic manometry and colonic biopsies. Demographic data, medication history, surgical history, colonic manometry results (gastrocolonic response to a meal, high-amplitude propagating contractions, and nonpropagating contractions), colonic manometry catheter position, and pathologic results were collected and analyzed. We compared those variables with outcome (need for surgery) between both patient groups (presence or absence of melanosis coli).

Results

A total of 150 patients were included, median age was 9.9 years (range 2.1–18) and 77 (51.3%) were female, 17 had melanosis. Patients who took sennosides had higher rates of melanosis coli compared to those who did not (adjusted OR 13.88; 95% CI 4.05–47.57; P < 0.001), and we did not find an association between melanosis coli and use of other medications (osmotic laxatives, bisacodyl, lubiprostone), age, gender, weight, and height. We found no significant difference in the results colonic manometry between patients with and without melanosis coli. The rates of surgery for constipation between patients with and without melanosis coli were not statistically different. (OR 3.00; 95% CI 0.45–20.07; P = 0.257).

Conclusions

Melanosis coli is associated with sennosides use, but it does not influence colonic motility nor is associated with increased subsequent need for surgery in pediatric functional constipation.

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Authors and Affiliations

  1. Division of Gastroenterology, Department of Pediatrics, Harvard Medical School, Boston Children’s Hospital, Boston, MA, USA

    Jeng-Jung Chen, R. N. Kitzia Colliard, Samuel Nurko & Leonel Rodriguez

  2. Department of Pediatrics, Mackay Memorial Hospital, Hsinchu, Taiwan

    Jeng-Jung Chen

  3. Section of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Yale School of Medicine, Yale New Haven Children’s Hospital, 333 Cedar Street, New Haven, CT, 06510, USA

    Leonel Rodriguez

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  1. Jeng-Jung Chen
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  2. R. N. Kitzia Colliard
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  3. Samuel Nurko
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  4. Leonel Rodriguez
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Contributions

JJC participated in the study design, data analysis, manuscript drafting and approval. KC participated in the study design, data collection and analysis, manuscript drafting and approvals. SN participated in the study design, data collection, manuscript drafting and approval. LR participated in the study design, data collection and analysis, manuscript drafting and approval.

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Correspondence to Leonel Rodriguez.

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Chen, JJ., Kitzia Colliard, R.N., Nurko, S. et al. Melanosis Coli Is Not Associated with Colonic Dysmotility Nor Severity of Pediatric Functional Constipation. Dig Dis Sci 67, 3922–3928 (2022). https://doi.org/10.1007/s10620-021-07191-z

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  • DOI: https://doi.org/10.1007/s10620-021-07191-z

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