{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T19:55:52Z","timestamp":1778010952433,"version":"3.51.4"},"reference-count":12,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2023,5,11]],"date-time":"2023-05-11T00:00:00Z","timestamp":1683763200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,5,11]],"date-time":"2023-05-11T00:00:00Z","timestamp":1683763200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Gastroenterol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Inadequate bowel preparation for colonoscopy remains an issue resulting in lower adenoma detection rates and increased cost. We assessed the efficacy, safety and tolerability of high-dose bowel preparations in subjects who previously had an inadequate colonoscopy preparation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed a multi-step prospective trial of high-dose bowel preparations with subjects assigned to the dose higher than their previous inadequate preparation. Step 1: 1.5 times the standard-dose of polyethylene glycol 3350 (PEG, 459\u00a0g) and Gatorade; and Step 2: 2.0 times the standard-dose of PEG (612\u00a0g) and Gatorade, both were given as extended split-dose preparations. 69 outpatients consumed their preparation before a morning colonoscopy. The primary endpoint was colon cleanliness assessed by the Chicago bowel preparation scale (BPS). Safety was assessed by comparing a baseline basic metabolic panel (BMP) to a post-cleansing BMP. Patients with no history of inadequate colon cleansing who consumed standard doses of PEG (306\u00a0g to 357\u00a0g) and Gatorade were used as a comparison group. Tolerability of the bowel preparation was assessed using a subject-questionnaire.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      When compared to controls consuming standard-dose bowel preparations, subjects consuming high-dose preparations had no statistically significant difference in colon cleanliness as measured by the modified or total Chicago BPS scores or differences in tolerability. Baseline and post-cleaning BMPs were not significantly different other than the BUN falling (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001) after the preparation.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The multi-step high-dose bowel cleansing protocol proved highly efficacious, safe and well tolerated in subjects who previously had an inadequate colonoscopy preparation.<\/jats:p>\n                    <jats:p>\n                      <jats:italic>Trial registration<\/jats:italic>\n                      : ClinicalTrials.gov NCT02661750.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12876-023-02663-0","type":"journal-article","created":{"date-parts":[[2023,5,11]],"date-time":"2023-05-11T04:06:22Z","timestamp":1683777982000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["High-dose polyethylene glycol-3350 and gatorade solutions for patients with previous inadequate bowel preparations for colonoscopy are safe and effective"],"prefix":"10.1186","volume":"23","clinical-trial-number":[{"clinical-trial-number":"nct02661750","registry":"10.18810\/clinical-trials-gov"}],"author":[{"given":"David P.","family":"Gerard","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sophia F.","family":"Gerard","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manfred W.","family":"Raiser","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2023,5,11]]},"reference":[{"key":"2663_CR1","unstructured":"Bucci C, Rotondano G, Hassan C, et al. Optimal bowel cleansing for colonoscopy: split the dose! A series of meta-analyses of controlled studies. Gastrointest Endosc 2014.pii:S0016-5107(14)01810-0."},{"key":"2663_CR2","doi-asserted-by":"publisher","first-page":"744","DOI":"10.1016\/j.gie.2017.06.012","volume":"87","author":"MA Kluge","year":"2018","unstructured":"Kluge MA, Williams JL, Wu CK, et al. Inadequate Boston Bowel Preparation Scale scores predict the risk of missed neoplasia on the next colonoscopy. Gastrointest Endosc. 2018;87:744\u201351.","journal-title":"Gastrointest Endosc"},{"key":"2663_CR3","doi-asserted-by":"crossref","unstructured":"ASGE Standards of Practice Committee, Saltzman JR, Cash BD, Pasha SF, et al. Bowel preparation before colonoscopy. Gastrointest Endosc. 2015;81:781\u201394","DOI":"10.1016\/j.gie.2014.09.048"},{"issue":"3 Pt 2","key":"2663_CR4","doi-asserted-by":"publisher","first-page":"626","DOI":"10.1016\/j.gie.2008.08.027","volume":"69","author":"S Ben-Horin","year":"2009","unstructured":"Ben-Horin S, Bar-Meir S, Avidan B. The outcome of a second preparation for colonoscopy after preparation failure in the first procedure. Gastrointest Endosc. 2009;69(3 Pt 2):626\u201330.","journal-title":"Gastrointest Endosc"},{"key":"2663_CR5","doi-asserted-by":"publisher","first-page":"1578","DOI":"10.1097\/DCR.0b013e31823434c8","volume":"54","author":"M Ib\u00e1\u00f1ez","year":"2011","unstructured":"Ib\u00e1\u00f1ez M, Parra-Blanco A, Zaballa P, et al. Usefulness of an intensive bowel cleansing strategy for repeat colonoscopy after preparation failure. Dis Colon Rectum. 2011;54:1578\u201384.","journal-title":"Dis Colon Rectum"},{"key":"2663_CR6","doi-asserted-by":"publisher","first-page":"951","DOI":"10.1038\/ajg.2017.53","volume":"112","author":"AZ Gimeno-Garc\u00eda","year":"2017","unstructured":"Gimeno-Garc\u00eda AZ, Hernandez G, Aldea A, et al. Comparison of two intensive bowel cleansing regimens in patients with previous poor bowel preparation: a randomized controlled study. Am J Gastroenterol. 2017;112:951\u20138.","journal-title":"Am J Gastroenterol"},{"key":"2663_CR7","doi-asserted-by":"publisher","first-page":"675","DOI":"10.1053\/j.gastro.2017.01.027","volume":"152","author":"JS Fordtran","year":"2017","unstructured":"Fordtran JS, Hofmann AF. Seventy years of polyethylene glycols in gastroenterology: the journey of PEG 4000 and 3350 From nonabsorbable marker to colonoscopy preparation to osmotic laxative. Gastroenterology. 2017;152:675\u201380.","journal-title":"Gastroenterology"},{"key":"2663_CR8","doi-asserted-by":"publisher","first-page":"512","DOI":"10.1097\/MCG.0000000000000575","volume":"51","author":"DP Gerard","year":"2017","unstructured":"Gerard DP, Foster DB, Holden JL, et al. Clinical trial of 1000 subjects randomized to 5 low-volume bowel preparations for colonoscopy and their acceptance of split-dose bowel preparations. J Clin Gastroenterol. 2017;51:512\u201321.","journal-title":"J Clin Gastroenterol"},{"key":"2663_CR9","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1038\/ctg.2012.11","volume":"3","author":"DP Gerard","year":"2012","unstructured":"Gerard DP, Holden JL, Foster DB, et al. Randomized trial of Gatorade\/polyethylene glycol with or without bisacodyl and NuLYTELY for colonoscopy preparation. Clin Transl Gastroenterol. 2012;3:1\u20139.","journal-title":"Clin Transl Gastroenterol"},{"key":"2663_CR10","doi-asserted-by":"publisher","first-page":"e43","DOI":"10.1038\/ctg.2013.16","volume":"4","author":"DP Gerard","year":"2013","unstructured":"Gerard DP, Foster DB, Raiser MW, et al. Validation of a new bowel preparation scale for measuring colon cleansing for colonoscopy: the Chicago Bowel Preparation scale. Clin Transl Gastroenterol. 2013;4:e43.","journal-title":"Clin Transl Gastroenterol"},{"key":"2663_CR11","doi-asserted-by":"publisher","first-page":"620","DOI":"10.1016\/j.gie.2008.05.057","volume":"69","author":"EJ Lai","year":"2009","unstructured":"Lai EJ, Calderwood AH, Doros G, et al. The Boston Bowel Preparation scale: a valid and reliable instrument for colonoscopy oriented research. Gastrointest Endosc. 2009;69:620\u20135.","journal-title":"Gastrointest Endosc"},{"key":"2663_CR12","doi-asserted-by":"publisher","first-page":"933","DOI":"10.1016\/0016-5085(88)90550-1","volume":"94","author":"LR Schiller","year":"1988","unstructured":"Schiller LR, Emmett M, Santa Ana CA, et al. Osmotic effects of polyethylene glycol. Gastroenterology. 1988;94:933\u201341.","journal-title":"Gastroenterology"}],"container-title":["BMC Gastroenterology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12876-023-02663-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12876-023-02663-0\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12876-023-02663-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,5,11]],"date-time":"2023-05-11T04:07:54Z","timestamp":1683778074000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcgastroenterol.biomedcentral.com\/articles\/10.1186\/s12876-023-02663-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,5,11]]},"references-count":12,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2023,12]]}},"alternative-id":["2663"],"URL":"https:\/\/doi.org\/10.1186\/s12876-023-02663-0","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-1894267\/v1","asserted-by":"object"}]},"ISSN":["1471-230X"],"issn-type":[{"value":"1471-230X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,5,11]]},"assertion":[{"value":"25 July 2022","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"1 February 2023","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"11 May 2023","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Approved by the AMITA Institutional Review Board (AMITA 2015-0004-02). All methods were carried out in accordance with relevant guidelines and regulations. Informed consent was obtained from all subjects.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"146"}}