Reviewer ’s report  
 
Title: Healthcare use by 30,000 patients with Irritable bowel syndrome (IBS) in France: a 5 -year 
retrospective and one -year prospective national observational study  
 
Version: 0 Date: 02 Dec 2018  
 
Reviewer: Massimo Bellini  
 
Reviewer's report:  
 
This is a very interesting paper dealing with an important matter i.e. the health care use  by IBS 
patients.  
The paper is well written  
- ABSTRACT  Conclusion: the authors use the acronym e SNDS (Systeme National des…)  
which is not fully mentioned before  
My main concern with this paper is whether using the data coming from hospitalization records 
is correct in order to describe the healthcare use by "general" IBS patients.  
Authors should probably  change the title ("Healthcare use by 30000 HOSPITALIZED patients 
with IBS ...")  
Was the main reason for admission abdominal symptoms attributable to IBS or other reason?  
In the first case these would be particularly serious patient s and this should be emphasized in the 
discussion because it is notrepresentative of all IBS patients.  
On the other hand, if the reasons for hospitalization were different, it would be advisable to 
separate the group of patients in which the main reason we re IBS symptoms from the group of 
patients reporting different reason for hospitalization (a sort of control group) .  
Probably in the discussion the authors could use the recent paper by Soncini M. et al recently 
published in DLD 2018 "IBS clinical managem ent in Italy: The AIGO survey".  
Are the me thods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Unable to assess  
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manuscript or would you recommend an  
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects require further  
assessment in your comments to the editors.  
 
Not relevant to this manuscript  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from an  
organisation that may in any way gain or lose financially from the publication of this  
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose  
financially from the publication of this manuscript, either now or in the futu re? 
 
3. Do you hold or are you currently applying for any patents relating to the content of the  
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds  or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I declare that I have no competing interests' 
below.  If your reply is yes to any, please give details below.  
 
I declare that I have no competing inte rests' below. If your reply is yes to any, please give details  
below.  
 
I agree to the open peer review policy of the journal. I understand that my name will be included  
on my report to the authors and, if the manuscript is accepted for publication, my named report  
including any attachments I upload will be posted on the website along with the authors'  
responses. I agree for my report to be made available under an Open Acc ess Creative Commons  
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments  
which I do not wish to be included in my named report can be included as confidential comments  
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
Reviewer ’s report  
 
Title: Healthcare use by 30,000 patients with Irritable bowel syndrome (IBS) in France: a 5 -year 
retrospective and one -year prospective national observational study  
 
Version: 0 Date: 02 Dec 2018  
 
Reviewer: Massimo Bellini  
 
Reviewer's report:  
 
This is a very interesting paper dealing with an important matter i.e. the health care use  by IBS 
patients.  
The paper is well written  
- ABSTRACT  Conclusion: the authors use the acronym e SNDS (Systeme National des…)  
which is not fully mentioned before  
My main concern with this paper is whether using the data coming from hospitalization records 
is correct in order to describe the healthcare use by "general" IBS patients.  
Authors should probably  change the title ("Healthcare use by 30000 HOSPITALIZED patients 
with IBS ...")  
Was the main reason for admission abdominal symptoms attributable to IBS or other reason?  
In the first case these would be particularly serious patient s and this should be emphasized in the 
discussion because it is notrepresentative of all IBS patients.  
On the other hand, if the reasons for hospitalization were different, it would be advisable to 
separate the group of patients in which the main reason we re IBS symptoms from the group of 
patients reporting different reason for hospitalization (a sort of control group) .  
Probably in the discussion the authors could use the recent paper by Soncini M. et al recently 
published in DLD 2018 "IBS clinical managem ent in Italy: The AIGO survey".  
Are the me thods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Unable to assess  
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manuscript or would you recommend an  
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects require further  
assessment in your comments to the editors.  
 
Not relevant to this manuscript  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from an  
organisation that may in any way gain or lose financially from the publication of this  
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose  
financially from the publication of this manuscript, either now or in the futu re? 
 
3. Do you hold or are you currently applying for any patents relating to the content of the  
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds  or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I declare that I have no competing interests' 
below.  If your reply is yes to any, please give details below.  
 
I declare that I have no competing inte rests' below. If your reply is yes to any, please give details  
below.  
 
I agree to the open peer review policy of the journal. I understand that my name will be included  
on my report to the authors and, if the manuscript is accepted for publication, my named report  
including any attachments I upload will be posted on the website along with the authors'  
responses. I agree for my report to be made available under an Open Acc ess Creative Commons  
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments  
which I do not wish to be included in my named report can be included as confidential comments  
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
Please review this paper.
user
Reviewer ’s report  
 
Title: Healthcare use by 30,000 patients with Irritable bowel syndrome (IBS) in France: a 5 -year 
retrospective and one -year prospective national observational study  
 
Version: 0 Date: 02 Dec 2018  
 
Reviewer: Massimo Bellini  
 
Reviewer's report:  
 
This is a very interesting paper dealing with an important matter i.e. the health care use  by IBS 
patients.  
The paper is well written  
- ABSTRACT  Conclusion: the authors use the acronym e SNDS (Systeme National des…)  
which is not fully mentioned before  
My main concern with this paper is whether using the data coming from hospitalization records 
is correct in order to describe the healthcare use by "general" IBS patients.  
Authors should probably  change the title ("Healthcare use by 30000 HOSPITALIZED patients 
with IBS ...")  
Was the main reason for admission abdominal symptoms attributable to IBS or other reason?  
In the first case these would be particularly serious patient s and this should be emphasized in the 
discussion because it is notrepresentative of all IBS patients.  
On the other hand, if the reasons for hospitalization were different, it would be advisable to 
separate the group of patients in which the main reason we re IBS symptoms from the group of 
patients reporting different reason for hospitalization (a sort of control group) .  
Probably in the discussion the authors could use the recent paper by Soncini M. et al recently 
published in DLD 2018 "IBS clinical managem ent in Italy: The AIGO survey".  
Are the me thods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Unable to assess  
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manuscript or would you recommend an  
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects require further  
assessment in your comments to the editors.  
 
Not relevant to this manuscript  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from an  
organisation that may in any way gain or lose financially from the publication of this  
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose  
financially from the publication of this manuscript, either now or in the futu re? 
 
3. Do you hold or are you currently applying for any patents relating to the content of the  
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds  or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I declare that I have no competing interests' 
below.  If your reply is yes to any, please give details below.  
 
I declare that I have no competing inte rests' below. If your reply is yes to any, please give details  
below.  
 
I agree to the open peer review policy of the journal. I understand that my name will be included  
on my report to the authors and, if the manuscript is accepted for publication, my named report  
including any attachments I upload will be posted on the website along with the authors'  
responses. I agree for my report to be made available under an Open Acc ess Creative Commons  
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments  
which I do not wish to be included in my named report can be included as confidential comments  
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
assistant