Melanosis Coli After Long-Term Ingestion of Cape Aloe

A73-year-oldwhitemalepresented toa tertiary center after an initial colonoscopy at an outside hospital showed at least 15 polyps, the largestmeasuring2.3 cm. Thepatientdeniedany family history of colorectal neoplasia and has undergone several colonoscopies since that time with mucosal resection of numerous polyps throughout the colon. The largest polyp was a 2.3-cm tubular adenoma in the cecum. The severity of his melanosis coli functioned similarly to chromoendoscopy to highlight the location of his polyps (Figure 1). His medication list included aspirin, diltiazem, finasteride, colesevelam, and vitamin C. Upon further questioning, the patient reported taking anherbal laxative calledCapeAloe for the past several years,which is likely responsible forhismelanosis coli.