DOI: https://doi.org/10.36347/sjams.2025.v13i10.011

Pages: 1755-1757

Background: Melanosis coli is a benign pigmentation of the colonic mucosa, most commonly associated with chronic laxative use. The condition is caused by accumulation of lipofuscin within macrophages in the lamina propria. Although often incidental, its recognition is important to avoid misinterpretation as more serious colonic pathology. Case Presentation: We report the case of a 70-year-old man with chronic constipation for several years, who developed colonic melanosis while using an inulin-based laxative daily. Colonoscopy revealed diffuse brown-black pigmentation predominantly in the right colon, confirmed histologically as melanosis coli. After discontinuation of the laxative and implementation of dietary and lifestyle changes, the patient’s bowel function improved and pigmentation regressed over time. Conclusion: This case illustrates melanosis coli related to prolonged use of an inulin-based laxative. Awareness of this benign and reversible entity is crucial to prevent unnecessary alarm and to emphasize rational laxative use in elderly patients with chronic constipation.