Title: A retrospective cohort study on oesophageal food bolus obstruction in the North Denmark
Region in 2021 - two thirds were never diagnosed with a cause
Version: 2 Date: 07 Oct 2023
Reviewer's report:
This is a clinically relevant paper on an important topic – What happens with patients who
experience food bolus obstruction in their oesophagus (FBO)?
The authors’ main aim of the study is to evaluate adherence to the Danish recommendation of
an upper GI endoscopy within two weeks with endoscopic biopsies. In clinical practice benign
disorders dominate the underlying cause of FBO, but in the majority of the patients, no diagnosis
is found. Benign esophageal diseases in turn, with or without FBO, usually develop over several
years before they are properly diagnosed. Therefore, endoscopy within two weeks after FBO
may be  recommendable, but according to the authors, mainly recommended to find or rule out
underlying malignant oesophageal  or gastric disease.
1. There is little written in the discussion about the importance to find underlying malignant
disease, the obvious real cause of recommendations of endoscopy at latest two weeks after FBO.
2. The authors have put a lot of effort in drawing nice and easily read graphs on their results.
One can for example see that overall 20.7 % of the patients never had an endoscopy (fig 1a).
An important question is what happened to this group? Were they already taken care of and
diagnosed with benign or malignant disorders? Please clarify why no information was given
on this important group, and even better include more profound information on later diagnoses
given to these patients.
3. Fig 2 says that 5.3 % of the patients sooner or later had a malignant cause of FBO.
How is this group related to the group mentioned above who never had an endoscopy?
Title: A retrospective cohort study on oesophageal food bolus obstruction in the North Denmark
Region in 2021 - two thirds were never diagnosed with a cause
Version: 2 Date: 07 Oct 2023
Reviewer's report:
This is a clinically relevant paper on an important topic – What happens with patients who
experience food bolus obstruction in their oesophagus (FBO)?
The authors’ main aim of the study is to evaluate adherence to the Danish recommendation of
an upper GI endoscopy within two weeks with endoscopic biopsies. In clinical practice benign
disorders dominate the underlying cause of FBO, but in the majority of the patients, no diagnosis
is found. Benign esophageal diseases in turn, with or without FBO, usually develop over several
years before they are properly diagnosed. Therefore, endoscopy within two weeks after FBO
may be  recommendable, but according to the authors, mainly recommended to find or rule out
underlying malignant oesophageal  or gastric disease.
1. There is little written in the discussion about the importance to find underlying malignant
disease, the obvious real cause of recommendations of endoscopy at latest two weeks after FBO.
2. The authors have put a lot of effort in drawing nice and easily read graphs on their results.
One can for example see that overall 20.7 % of the patients never had an endoscopy (fig 1a).
An important question is what happened to this group? Were they already taken care of and
diagnosed with benign or malignant disorders? Please clarify why no information was given
on this important group, and even better include more profound information on later diagnoses
given to these patients.
3. Fig 2 says that 5.3 % of the patients sooner or later had a malignant cause of FBO.
How is this group related to the group mentioned above who never had an endoscopy?
Please review this paper.
user
Title: A retrospective cohort study on oesophageal food bolus obstruction in the North Denmark
Region in 2021 - two thirds were never diagnosed with a cause
Version: 2 Date: 07 Oct 2023
Reviewer's report:
This is a clinically relevant paper on an important topic – What happens with patients who
experience food bolus obstruction in their oesophagus (FBO)?
The authors’ main aim of the study is to evaluate adherence to the Danish recommendation of
an upper GI endoscopy within two weeks with endoscopic biopsies. In clinical practice benign
disorders dominate the underlying cause of FBO, but in the majority of the patients, no diagnosis
is found. Benign esophageal diseases in turn, with or without FBO, usually develop over several
years before they are properly diagnosed. Therefore, endoscopy within two weeks after FBO
may be  recommendable, but according to the authors, mainly recommended to find or rule out
underlying malignant oesophageal  or gastric disease.
1. There is little written in the discussion about the importance to find underlying malignant
disease, the obvious real cause of recommendations of endoscopy at latest two weeks after FBO.
2. The authors have put a lot of effort in drawing nice and easily read graphs on their results.
One can for example see that overall 20.7 % of the patients never had an endoscopy (fig 1a).
An important question is what happened to this group? Were they already taken care of and
diagnosed with benign or malignant disorders? Please clarify why no information was given
on this important group, and even better include more profound information on later diagnoses
given to these patients.
3. Fig 2 says that 5.3 % of the patients sooner or later had a malignant cause of FBO.
How is this group related to the group mentioned above who never had an endoscopy?
assistant