The Brown Bowel Syndrome is so named because of the gross appearance of the intestines in advanced cases.


Synonym: intestinal lipofuscinosis


Pathophysiology: mitochondrial myopathy secondary to vitamin E deficiency that affects smooth muscle cells



(1) brown coloration to the intestines (in less severe cases may be "darker than normal")

(2) presence of malabsorption

(3) presence bowel dilatation due to hypotonia and/or atonia (poor contractility)

(4) presence of a large amount of brown lipofuscin pigment in the smooth muscle layers of the bowel wall and blood vessels

(5) vitamin E deficiency that is usually mixed with other nutritional deficiencies (moderate to severe malnutrition)


Correction of the vitamin E and nutritional deficiencies may result in partial but often not complete correction of the problem.


Differential diagnosis:

(1) melanosis coli (pigment is within macrophages in the lamina propria)


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