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Patient satisfaction and best-quality care can be at odds when it comes to bowel preparation choice for colonoscopy. Should gastroenterologists be advising patients of the risks associated with choosing a preparation that might taste better but does not clean the colon as well as another (i.e., a split-dosed, polyethylene glycol–based prep)? What preparations are gastroenterologists choosing for their patients? Dr. M. Brian Fennerty lays out this issue and his thoughts. Read Gut Check and contribute to the discussion.