7212 Cinnamon chewing gum mimicking colonic polyps: a case report.

Abstract

The ideal colonoscopy preparation requires that bowel is clean and free of fecal matter, which may block suction channel. Also certain drugs should be avoided such as iron tablets, aspirin or anticoagulants for 4-5 days prior to procedure. We describe a patient in whom cinnamon chewing gum taken night before was mimicking colonic polyps. Case Report: A 55-year-old male with history of constipation and a few episodes of mild rectal bleeding after straining was scheduled for colonoscopy. He denied weight loss or family history of colonic carcinoma. His physical examination was unremarkable and routine labs within normal limits. Even though it was clinically evident that bleeding was from an anorectal source, because of his age he underwent full colonoscopy. The standard bowel preparation with liquid diet and one gallon of Golytely solution evening before was applied. Colonoscopy was performed up to cecum. Preparation was adequate. Grade 1-2 internal hemorrhoids were noticed otherwise colonic mucosa was normal throughout. In cecum opposite to ileocecal valve there was a polypoid lesion 7-8 mm in size, pinkish, round, smooth, nearly attached to mucosa looking like an adenomatous polyp. After photos, trainee was prepared for polypectomy when it was noticed that the polyp moved away from original position. During withdrawal a similar, but smaller piece was noted at splenic flexure. By asking patient he admitted that he took red cinnamon gum night before procedure and he kept empty pack in his pocket, which gave to endoscopy staff. Pathology report for documentation: vegetable matter, consistent with foreign body. Conclusion: Cinnamon chewing gum may mimic adenomatous colonic polyps but most important because of their consistency any gums may block suction channel more than feces; therefore recommendation to patients to avoid chewing gum day before colonoscopy should be made.