Abstract
phages, and they are converted to lipofuscin as macrophages migrate to the lamina propria of the mucosa.3,4 Moreover, results in animal experiments have suggested that long-term administration of anthraquinone cathartics not only causes changes in the intestinal mucosa but also affects the intestinal plexuses to further aggravate constipation.5 Bamboo leaf extract, which is prepared primarily from leaves of kumaisasa, is sold as a dark green fluid. There have been reports that lignin, one of its components, exhibited anti-tumor effects in animals bearing benzopyrene-induced and 4-nitroquinoline-1-oxide (4NOQ)-induced tumors6 and that it alleviated alcoholic fatty liver in rats.7 In acute and subacute toxicity studies, impaired liver and kidney functions were observed in rats given lignin at high doses.8 Because bamboo leaf extract was not ordinarily ingested by humans, the possibility of its deposition in the intestinal mucosa has not been considered. There have been no reports on the safety of its long-term administration, and the question remains open. The evidence in this report is circumstantial as the patient was not rechallenged, but dose suggest a possible association between Melanosis coli and ingestion of bamboo leaf extract. There may be differences between the histologic changes induced by anthraquinone laxatives and bamboo leaf extract although no firm conclusion can be reached based on study of a single patient.
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