There were no survivors. [Warning: GRAPHIC]

Colorectal Cancer Awareness Month continues on! However let’s face it, awareness by itself is not enough! To have an impact, we need to take action against colon cancer. We must also have the necessary tools, tactics, and training to take care of business when polyps rear their ugly head. It's a bad month to be a polyp!!!

Frozen stool for fecal transplant: Better, faster, less messy!

It was only a matter of time that a fecal transplant product was created. Now instead of having to test an individual donor and mix the stool to prepare the specimen for delivery through the scope, one can simply call the hospital pharmacy several hours before the fecal transplant is scheduled and order a 250 mL bottle of frozen donor stool from OpenBiome.

Retroflexion in the right colon: How to do it.

Since the name of my site is Retroflexions, it's about time I wrote an article about how to retroflex! More specifically, how does one retroflex in the right colon? (Fair warning: This article is probably only interesting to gastroenterologists.)

Retroflexion as a necessary maneuver to resect a large colonic polyp.

Sometimes repositioning the lesion is what it takes to get it done. A better angle between the snare and the polyp can be the difference between sliding over the top or capturing the lesion. In this case, retroflexing the scope in the ascending colon was the key maneuver needed to get the rest of the polyp out.

Find the hidden polyp! Colon cancer screening in action!

I thought it would be a good time to show a real-life example of colorectal cancer prevention in action. Let's pretend that you are a friendly neighborhood gastroenterologist, just minding your own business and doing a screening colonoscopy on a patient.

Tips on handling big polyps that you are not going to remove

Knowing your limits is a very important part of doctoring. As Mark Twain said, "Good decisions come from experience. Experience comes from making bad decisions." Tackling big polyps with the scope is no exception to this rule. Although techniques for removing large polyps have evolved over the years, and maneuvers that were once deemed "high-risk" are now being taught fairly routinely to junior GI fellows, there is still an individual comfort level that practitioners should identify in themselves and respect.

Gastroenterologists are tattoo artists of the colon

It is common practice to leave a permanent tattoo at the site of significant pathology ( such as a large polyp or tumor) inside the GI tract. We typically use a substance called SPOT, which consists of microscopic carbon particles in a suspension. When injected into tissue it becomes a permanent mark that can be seen from the inside of the organ with the scope, and from the outside of the organ by a surgeon.

Flat “polyp” resection (part one)

This lesion exhibits the "mucus cap" sign. There is a thick layer of mucus adherent to the polyp that remains attached even after washing with the water jet on the scope. The mucus cap sign is often seen with a particular type of polyp called a serrated polyp. These are often located in the right side of the colon, and are thought to be easier to miss on colonoscopy due to the flat nature of their growth. Unfortunately, they can still transform into colon cancer.

How to do a fecal microbiota transplant

This will just be a cookbook-style post on how we do fecal microbiota transplant with colonoscopy. First, a healthy donor must be identified. The donor should be in good general health, since theoretically some problems such as obesity, diabetes, autoimmune disease, etc., may be transmitted by fecal transplant.

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