A 25 year old colonscopy showed pigmentary deposits and microscopy showed pigment laden macrophages. The women in on laxatives for past one year. Which of the following is the cause of it ?
**Core Concept**
Pigmentary deposits in the colon, specifically melanosis coli, are a result of chronic exposure to certain substances that lead to the accumulation of pigment-laden macrophages. This condition is often associated with the long-term use of certain laxatives.
**Why the Correct Answer is Right**
The correct answer is related to the use of anthraquinone laxatives, such as senna and cascara sagrada. These laxatives contain anthranoid compounds that are broken down by gut bacteria into anthrones, which are then absorbed and excreted in the bile. The anthrones accumulate in the colonic mucosa, leading to the formation of pigment-laden macrophages and melanosis coli. The chronic use of these laxatives over a year can lead to the characteristic pigmentary deposits observed in the colon.
**Why Each Wrong Option is Incorrect**
**Option A:** This option is incorrect because it does not accurately describe the cause of melanosis coli. While certain medications can cause pigmentation in the skin, they are not typically associated with melanosis coli.
**Option B:** This option is incorrect because it refers to a different condition altogether. Melanosis coli is not caused by the ingestion of iron, which can lead to different types of gastrointestinal symptoms.
**Option C:** This option is incorrect because it does not accurately describe the cause of melanosis coli. While certain dietary factors can affect the color of stool, they are not typically associated with melanosis coli.
**Option D:** This option is incorrect because it does not accurately describe the cause of melanosis coli. While certain infections can cause gastrointestinal symptoms, they are not typically associated with melanosis coli.
**Clinical Pearl / High-Yield Fact**
Chronic use of anthraquinone laxatives can lead to melanosis coli, characterized by pigmentary deposits and pigment-laden macrophages in the colon. This condition is often reversible upon discontinuation of the offending laxative.
**Correct Answer:** C.