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Apart from laxative abuse, melanosis coli has been reported as a consequence of long standing inflammatory bowel disease.7 The authors concluded that chronic colitis could also cause melanosis coli without laxative abuse

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doi: 10.1038/s41368-024-00329-5 191 DengYChenXZhangZZhaoXZhuZWuCet al

These are all injuries that require time to heal yet will hurt for the duration of the healing process