Bedford et al1 report the results of their survey of hyoscine (Buscopan) use during colonoscopy and ask if th e current British Society of Gastroenterology (BSG) guidelines in this area should be modified as a consequence. Current BSG guidance recommends ‘…Buscopan should therefore be used cautiously at the lowest possible dose or avoided in… patients with a history of closed angle glaucoma’. Despite the known limitations in interpretation of surveys and without dwelling on these, the authors do serendipitously raise the important question of colonoscopy quality and understanding of interventions used in practice to improve it. It is interesting that over the past decade the overwhelming focus on improvement in quality of colonoscopy has resulted in various surrogate measures such as caecal intubation rates, adenoma detection rates, withdrawal times, etc., …