Reviewer's report
Title:A rapid, simple questionnaire to assess gastrointestinal symptoms after 1
oral ferrous sulphate supplementation.
Version:1Date:18 April 2014
Reviewer: Christophe Chassard
Reviewer's report:
The manuscript by Pereira et al. reports the evaluation of a new questionnaire to
assess gastrointestinal symptoms during iron supplementation. The
questionnaire has been validated in a double-blind placebo-controlled
randomized parallel trial involving 20 volunteers. Despite the low number of
volunteers enrolled, assessment of gastrointestinal symptoms sounds promising
and rapid. The questionnaire provides a useful option to highlight the most
frequent symptoms usually reported. The data, methods and strategy shown in
the manuscript are of interest and appropriate to be discussed in BMC
Gastroenterology.
I have however some comments that are listed below.
Minor Essential Revisions
Background: authors should add to the section a short paragraph providing basic
information about regular iron supplementation strategies (different iron
compounds and forms, posology etc…). This would be helpful to understand why
they have selected ferrous iron.
Methods: did authors consider an alternative design for the study such as a
cross-sectional trial instead of a basic DBPC trial? Taking in account the low
number of volunteers involved, this design would have been more powerful in
term of statistical analysis. Please comment on this.
Table 2: It would be interesting to provide the P values even if statistical tests are
NS. This would help the reader to distinguish the border line P values and those
clearly far away from the significant value.
Results and discussion: in general, results should be more discussed. Authors
could add a few sentences trying to find explanations or connections between
ferrous sulphate supplementation and the most important gastrointestinal
symptoms revealed by the study.
Authors should also pay attention to the supplement itself. By using iron
sulphate, they obviously provide ferrous iron to the colonic microbiota but also a
lot of sulphate which could be primary responsible for the black stools by
promoting microbial sulfato-reduction. Sulphate-reducing bacteria need iron but
also sulphate for their growth and the use of iron fumarate or iron EDTA could
lead to substantial differences in the answers of volunteers in a similar
experiment.
L218: the term sulphate-reducing bacteria should be used instead of
sulphur-reducing bacteria. Please correct.
Level of interest: An article of importance in its field
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 rapid, simple questionnaire to assess gastrointestinal symptoms after 1
oral ferrous sulphate supplementation.
Version:1Date:18 April 2014
Reviewer: Christophe Chassard
Reviewer's report:
The manuscript by Pereira et al. reports the evaluation of a new questionnaire to
assess gastrointestinal symptoms during iron supplementation. The
questionnaire has been validated in a double-blind placebo-controlled
randomized parallel trial involving 20 volunteers. Despite the low number of
volunteers enrolled, assessment of gastrointestinal symptoms sounds promising
and rapid. The questionnaire provides a useful option to highlight the most
frequent symptoms usually reported. The data, methods and strategy shown in
the manuscript are of interest and appropriate to be discussed in BMC
Gastroenterology.
I have however some comments that are listed below.
Minor Essential Revisions
Background: authors should add to the section a short paragraph providing basic
information about regular iron supplementation strategies (different iron
compounds and forms, posology etc…). This would be helpful to understand why
they have selected ferrous iron.
Methods: did authors consider an alternative design for the study such as a
cross-sectional trial instead of a basic DBPC trial? Taking in account the low
number of volunteers involved, this design would have been more powerful in
term of statistical analysis. Please comment on this.
Table 2: It would be interesting to provide the P values even if statistical tests are
NS. This would help the reader to distinguish the border line P values and those
clearly far away from the significant value.
Results and discussion: in general, results should be more discussed. Authors
could add a few sentences trying to find explanations or connections between
ferrous sulphate supplementation and the most important gastrointestinal
symptoms revealed by the study.
Authors should also pay attention to the supplement itself. By using iron
sulphate, they obviously provide ferrous iron to the colonic microbiota but also a
lot of sulphate which could be primary responsible for the black stools by
promoting microbial sulfato-reduction. Sulphate-reducing bacteria need iron but
also sulphate for their growth and the use of iron fumarate or iron EDTA could
lead to substantial differences in the answers of volunteers in a similar
experiment.
L218: the term sulphate-reducing bacteria should be used instead of
sulphur-reducing bacteria. Please correct.
Level of interest: An article of importance in its field
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 rapid, simple questionnaire to assess gastrointestinal symptoms after 1
oral ferrous sulphate supplementation.
Version:1Date:18 April 2014
Reviewer: Christophe Chassard
Reviewer's report:
The manuscript by Pereira et al. reports the evaluation of a new questionnaire to
assess gastrointestinal symptoms during iron supplementation. The
questionnaire has been validated in a double-blind placebo-controlled
randomized parallel trial involving 20 volunteers. Despite the low number of
volunteers enrolled, assessment of gastrointestinal symptoms sounds promising
and rapid. The questionnaire provides a useful option to highlight the most
frequent symptoms usually reported. The data, methods and strategy shown in
the manuscript are of interest and appropriate to be discussed in BMC
Gastroenterology.
I have however some comments that are listed below.
Minor Essential Revisions
Background: authors should add to the section a short paragraph providing basic
information about regular iron supplementation strategies (different iron
compounds and forms, posology etc…). This would be helpful to understand why
they have selected ferrous iron.
Methods: did authors consider an alternative design for the study such as a
cross-sectional trial instead of a basic DBPC trial? Taking in account the low
number of volunteers involved, this design would have been more powerful in
term of statistical analysis. Please comment on this.
Table 2: It would be interesting to provide the P values even if statistical tests are
NS. This would help the reader to distinguish the border line P values and those
clearly far away from the significant value.
Results and discussion: in general, results should be more discussed. Authors
could add a few sentences trying to find explanations or connections between
ferrous sulphate supplementation and the most important gastrointestinal
symptoms revealed by the study.
Authors should also pay attention to the supplement itself. By using iron
sulphate, they obviously provide ferrous iron to the colonic microbiota but also a
lot of sulphate which could be primary responsible for the black stools by
promoting microbial sulfato-reduction. Sulphate-reducing bacteria need iron but
also sulphate for their growth and the use of iron fumarate or iron EDTA could
lead to substantial differences in the answers of volunteers in a similar
experiment.
L218: the term sulphate-reducing bacteria should be used instead of
sulphur-reducing bacteria. Please correct.
Level of interest: An article of importance in its field
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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