Dr. Loren Laine, MD, co-author of a new systematic review of the impact of bowel prep quality on early repeat colonoscopy and adenoma detection rate (ADR), talks with AJG Co-Editor Dr. William D. Chey about the real-world differences in ADR during colonoscopies with high, intermediate, and poor quality bowel preps. Meta-analysis of high-quality studies found no significant difference in ADR between high and intermediate quality preps, suggesting that intermediate preps might be “good enough.” Dr. Laine also discusses the impact of withdrawal time, documentation of prep quality, and recommendations for repeat colonoscopies after intermediate or poor quality preps. (20:55)