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 tissueKey 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 IntelligenceReferences 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