Introduction Terminal ileal (TI) images are reliable indicators of completeness of colonoscopy 1 . Studies have shown that TI image provide more convincing than caecal images to verify completion of colonoscopy 2 . Acquisitionof TI images after water insufflation (WI) has been found to produce reliable images 3 .We wanted to identify if TI images after WI through the biopsy channel or narrow band images of TI produce more reliable as part of image documentation. Methods 4 images of terminal

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... m were captured using Olympus colonoscope ®. They were 1 captured with conventional white light endoscopy (WLE), 1 captured with white light endoscopy + water insufflation (WLEWI), 1 captured with narrow band imaging (NBI) and 1 captured with NBI + water insufflation (NBIWI). Without informing that these were TI images, the 4 terminal images were sent to endoscopists by email along with an invitation to participate in a survey using survey monkey® portal. Using the survey the respondents marked each image as follows: not terminal ileum = 1, may be terminal ileum = 2, most likely terminal ileum = 3, definitely terminal ileum = 4. Results 36 endoscopists completed our survey. 49% were gastroenterology Specialist registrar, 40% were consultant gastroenterologists and 11% were colorectal surgeons. Most of the respondents (n = 31) were from the UK, 4 were from the United States and 1 was from the rest of the Europe. 19.4% (n = 7) of respondents had colonoscopy experience of 1-2 years, 30.6% (n = 11) had colonoscopy experience of 3-5 years, 19.4% (n = 7) had colonoscopy experience of 5-9 years 30.6% (n = 11) had colonoscopy experience of more than 10 years. Responses in Table 1: