Reviewer's report
Title:Medical and surgical treatment of haemorrhoids and anal fissure in Crohn's
disease: a critical appraisal.
Version: 5Date:15 August 2012
Reviewer: Richelle Jeannette Fyline Felt
Reviewer's report:
It is always interesting to read an article about anorectal problems. It is an
interesting subject and the treatment is contrioversial, therefore it makes the
article interesting. However, there are some serious remarks I would like to
make.
The article is too long and to worthy. The message of the authors is not very
complicated: it tels us what happpened to their patients, compare their results
with the literature and they try to come with an advice.
The literature does not need to be repeated both in backround and discussion.
The results section is far too long. I think the article could easily be brought back
to 60% of its size.
Specific comment:
Abstract:; no comment
Backround: last alinea: anal fistula? probably anal fissure?
Methods: abbrevation IRB should be mentioned.
Results: An important issue is that rubber band ligation was not considered a
conservative treatment. This makes a large difference in outcome. In many
contries beside the supportive measures likes fluid, fibers and mild laxatives this
is th eteratment of choice. Warm sit bath does not seem appropriate for
haemorroids: there are several studies thad advocate an anal cooler or ice packs
for hemoroids. This is an important issue and should also be mentioned in the
discussion why these choices were made. The effect of diosmin is very doubdfull
(DCR 1992). Lidocaine or zink ointment seems a good alternative.
In patients with an anal fisuure, a non posterior fistula should rase suspicion for a
non cryptoglandular ulcer? where there such ulcers in the non suspected Crohn
group?
Discussion: see remarks above. Important is the remark about the Rubber band
ligation: that is common practice in many countries. Minor spelling mistakes
Level of interest: An article whose findings are important to those with closely
related research interests
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:Medical and surgical treatment of haemorrhoids and anal fissure in Crohn's
disease: a critical appraisal.
Version: 5Date:15 August 2012
Reviewer: Richelle Jeannette Fyline Felt
Reviewer's report:
It is always interesting to read an article about anorectal problems. It is an
interesting subject and the treatment is contrioversial, therefore it makes the
article interesting. However, there are some serious remarks I would like to
make.
The article is too long and to worthy. The message of the authors is not very
complicated: it tels us what happpened to their patients, compare their results
with the literature and they try to come with an advice.
The literature does not need to be repeated both in backround and discussion.
The results section is far too long. I think the article could easily be brought back
to 60% of its size.
Specific comment:
Abstract:; no comment
Backround: last alinea: anal fistula? probably anal fissure?
Methods: abbrevation IRB should be mentioned.
Results: An important issue is that rubber band ligation was not considered a
conservative treatment. This makes a large difference in outcome. In many
contries beside the supportive measures likes fluid, fibers and mild laxatives this
is th eteratment of choice. Warm sit bath does not seem appropriate for
haemorroids: there are several studies thad advocate an anal cooler or ice packs
for hemoroids. This is an important issue and should also be mentioned in the
discussion why these choices were made. The effect of diosmin is very doubdfull
(DCR 1992). Lidocaine or zink ointment seems a good alternative.
In patients with an anal fisuure, a non posterior fistula should rase suspicion for a
non cryptoglandular ulcer? where there such ulcers in the non suspected Crohn
group?
Discussion: see remarks above. Important is the remark about the Rubber band
ligation: that is common practice in many countries. Minor spelling mistakes
Level of interest: An article whose findings are important to those with closely
related research interests
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:Medical and surgical treatment of haemorrhoids and anal fissure in Crohn's
disease: a critical appraisal.
Version: 5Date:15 August 2012
Reviewer: Richelle Jeannette Fyline Felt
Reviewer's report:
It is always interesting to read an article about anorectal problems. It is an
interesting subject and the treatment is contrioversial, therefore it makes the
article interesting. However, there are some serious remarks I would like to
make.
The article is too long and to worthy. The message of the authors is not very
complicated: it tels us what happpened to their patients, compare their results
with the literature and they try to come with an advice.
The literature does not need to be repeated both in backround and discussion.
The results section is far too long. I think the article could easily be brought back
to 60% of its size.
Specific comment:
Abstract:; no comment
Backround: last alinea: anal fistula? probably anal fissure?
Methods: abbrevation IRB should be mentioned.
Results: An important issue is that rubber band ligation was not considered a
conservative treatment. This makes a large difference in outcome. In many
contries beside the supportive measures likes fluid, fibers and mild laxatives this
is th eteratment of choice. Warm sit bath does not seem appropriate for
haemorroids: there are several studies thad advocate an anal cooler or ice packs
for hemoroids. This is an important issue and should also be mentioned in the
discussion why these choices were made. The effect of diosmin is very doubdfull
(DCR 1992). Lidocaine or zink ointment seems a good alternative.
In patients with an anal fisuure, a non posterior fistula should rase suspicion for a
non cryptoglandular ulcer? where there such ulcers in the non suspected Crohn
group?
Discussion: see remarks above. Important is the remark about the Rubber band
ligation: that is common practice in many countries. Minor spelling mistakes
Level of interest: An article whose findings are important to those with closely
related research interests
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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