In this episode we discuss using natural color changes called "biologic chromoendoscopy" to detect challenging flat colorectal lesions.

Key Topics Discussed:
- While sessile and pedunculated polyps are easy to spot endoscopically, flat and serrated lesions are challenging
- AI, virtual chromoendoscopy, and dyes aren't reliable for flat lesions obscured by mucus/debris
- Mucus changes light penetration, traps stool, and creates a hazy appearance
- Two mucin secretion changes: lost O-acetyl groups and increased sialylation
- "Chicken skin mucosa" refers to white spots from lipid-laden macrophages linked to adenomas, cancer, and juvenile polyps
- Melanosis coli is dark pigmentation from lipofuscin deposits due to chronic laxative use
- Recognizing subtle color changes is critical for finding precancerous flat lesions
- Human eye notices what AI systems miss when looking for discolored tissue

Key Quotes:
- "I call the lesions' natural color changes 'biologic chromoendoscopy.'"
- "Other examples are 'chicken skin mucosa' and melanosis coli."
- "Recognizing these subtle color changes is critical for finding precancerous flat lesions."

Links:
Biologic Chromoendoscopy – The Eye Beats Artificial Intelligence

References Made:
- Mucin secretion changes in serrated lesions
- Melanosis coli and anthraquinone laxative use
- Chicken skin mucosa first described in Japan 

Keywords:
- colorectal cancer screening
- colonoscopy  
- endoscopy
- polyp detection
- flat lesions
- sessile serrated lesions
- biologic chromoendoscopy
- natural chromoendoscopy
- chicken skin mucosa
- melanosis coli
- mucin secretion
- AI in endoscopy
- virtual chromoendoscopy
- chromoendoscopy techniques
- lipofuscin
- precancerous polyps
- colorectal polyps
- anthraquinone laxatives
- visual characterization of lesions
- hazy lesions
- discolored lesions

https://www.gastroendopod.com