Reviewer's report
Title:A survey of abnormalities in the colon and rectum in patients presenting
with haemorrhoids.
Version: 1Date:15 March 2010
Reviewer: Wilhelm Graf
Reviewer's report:
This is an observational study of patients undergoing colonoscopy for clinical
reasons with the purpose to detect colonic abnormalities in patients with
haemorrhoids. I have several questions and concerns.
1. I see no reson to exclude patients without haemorrhoids from the study, this
group should be an interesting control group for comparison.
2. The method of detecting haemorrhoids is not optimal nor well described.
Apparently, the main diagnostic tool is inspection, whereas it is best diagnosed
with anoscopy. The procedure for diagnosing haemorrhoids should be more
precise.
3. Some of the comparison the authors do are unwarranted, i.e. it is obvious that
patients with associated pathology are older and that sigmoidoscopy is less
effictive to detect proximal pathology.
4. Ethical permission for the study is not mentioned.
5. The authors conclude that colonoscopy is not necessary for patients below the
age of 50, however the number of patients in this group is too low to allow firm
conclusions.
6. Patients undergoing sigmoidsocopy were included in the study which is
questionable since the possibility to detect pathology is limited.
Level of interest: An article of limited interest
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
'I declare that I have no competing interests'
Reviewer's report
Title:A survey of abnormalities in the colon and rectum in patients presenting
with haemorrhoids.
Version: 1Date:15 March 2010
Reviewer: Wilhelm Graf
Reviewer's report:
This is an observational study of patients undergoing colonoscopy for clinical
reasons with the purpose to detect colonic abnormalities in patients with
haemorrhoids. I have several questions and concerns.
1. I see no reson to exclude patients without haemorrhoids from the study, this
group should be an interesting control group for comparison.
2. The method of detecting haemorrhoids is not optimal nor well described.
Apparently, the main diagnostic tool is inspection, whereas it is best diagnosed
with anoscopy. The procedure for diagnosing haemorrhoids should be more
precise.
3. Some of the comparison the authors do are unwarranted, i.e. it is obvious that
patients with associated pathology are older and that sigmoidoscopy is less
effictive to detect proximal pathology.
4. Ethical permission for the study is not mentioned.
5. The authors conclude that colonoscopy is not necessary for patients below the
age of 50, however the number of patients in this group is too low to allow firm
conclusions.
6. Patients undergoing sigmoidsocopy were included in the study which is
questionable since the possibility to detect pathology is limited.
Level of interest: An article of limited interest
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
'I declare that I have no competing interests'
Please review this paper.
user
Reviewer's report
Title:A survey of abnormalities in the colon and rectum in patients presenting
with haemorrhoids.
Version: 1Date:15 March 2010
Reviewer: Wilhelm Graf
Reviewer's report:
This is an observational study of patients undergoing colonoscopy for clinical
reasons with the purpose to detect colonic abnormalities in patients with
haemorrhoids. I have several questions and concerns.
1. I see no reson to exclude patients without haemorrhoids from the study, this
group should be an interesting control group for comparison.
2. The method of detecting haemorrhoids is not optimal nor well described.
Apparently, the main diagnostic tool is inspection, whereas it is best diagnosed
with anoscopy. The procedure for diagnosing haemorrhoids should be more
precise.
3. Some of the comparison the authors do are unwarranted, i.e. it is obvious that
patients with associated pathology are older and that sigmoidoscopy is less
effictive to detect proximal pathology.
4. Ethical permission for the study is not mentioned.
5. The authors conclude that colonoscopy is not necessary for patients below the
age of 50, however the number of patients in this group is too low to allow firm
conclusions.
6. Patients undergoing sigmoidsocopy were included in the study which is
questionable since the possibility to detect pathology is limited.
Level of interest: An article of limited interest
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
'I declare that I have no competing interests'
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