Frederick Gandolfo, MD

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.

I was surprised when the pathologist called me a few days later about the patient, since pathologists usually only call when a result is malignant or unusual. This "polyp" which I estimated to be about 15-mm in greatest diameter was a serrated adenoma (not a surprise) but also contained an 8-mm focus of adenocarcinoma. Luckily, the carcinoma portion of the polyp was completely resected with clear margins on all sides, however this polyp was truly an early-stage colon cancer!

Food impaction in the esophagus is one of the emergency conditions that only gastroenterologists and emergency room doctors know about. The overall concept is simple: Soon-to-be patient eats a large quantity of food (most commonly meat), which gets stuck in the esophagus somewhere and then causes a blockage and prevents further swallowing. Patient experiences chest pain,  … Read more

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.

Dysphagia (trouble swallowing) can be caused by many different problems. A strictured or narrowed esophagus is one common cause, and is often related to excess acid exposure in the esophagus. Usually strictures happen at one discrete location in the esophagus (often the lower part closest to the stomach where acid reflux damage is the most pronounced).

So what does this all mean? Should you never eat red meat? Is this the end of the bacon cheeseburger? Of course not! When faced with information like this we really need to step back and look at the big picture. How much do you enjoy eating a juicy steak or a grilled hot dog on a warm summer day? What is the purpose of life? What is the lifetime mortality of someone who never eats red meat? (Hint: it's 100%.) Let's not forget that red meat is also an excellent source of protein, iron, B vitamins, and zinc...oh, and it tastes pretty good too!