Reviewer's report 
 Partially Responsive Celiac Disease Resulting from Small Intestinal Bacterial Overgrowth and Title: 
Lactose Intolerance 
 2  14 January 2004 Version: Date: 
 carolina ciacci Reviewer: 
Reviewer's report: 
General 
The paper reports two cases of celiac disease with overt malabsorption syndrome. It is important that in Countries where celiac disease is considered uncommon the report of clinical cases of celiac disease. However, I have some concern about the concept that celiac disease may be considered 
partially responsive after only 40 days of GFD. In adults celiac disease may take months to recover 
despite strict GFD. SIBO can be a consequence of malabsorption as undigested food is a great pabulum for colon bacteria that may colonize ileum. It is unclear to me why tetracyclin had no effect in fist instance and full effect after 40 days when 
amalbsorpion is still present. 
Lactose malabsorption is described in the second case. Milk intolerance is common in celiac and general population. It is generally quite well tolerated. Beside the patient noticed even before 
diagnosis increase of watery stool after milk assumption. It is good practice to limit milk intake during 
first weeks/months of GFD in particular when overt malabsortion is present. 
I would suggest the Authors to better describe the number od celiac disease patients they have 
seen, the diet the patients were on before diagnosis. 
I do not see the utility of figures. 
 Reject because scientifically unsound What next?: 
 An article of limited interest Level of interest: 
 Acceptable Quality of written English: 
 No Statistical review: 
Declaration of competing interests: 
none 
Reviewer's report 
 Partially Responsive Celiac Disease Resulting from Small Intestinal Bacterial Overgrowth and Title: 
Lactose Intolerance 
 2  14 January 2004 Version: Date: 
 carolina ciacci Reviewer: 
Reviewer's report: 
General 
The paper reports two cases of celiac disease with overt malabsorption syndrome. It is important that in Countries where celiac disease is considered uncommon the report of clinical cases of celiac disease. However, I have some concern about the concept that celiac disease may be considered 
partially responsive after only 40 days of GFD. In adults celiac disease may take months to recover 
despite strict GFD. SIBO can be a consequence of malabsorption as undigested food is a great pabulum for colon bacteria that may colonize ileum. It is unclear to me why tetracyclin had no effect in fist instance and full effect after 40 days when 
amalbsorpion is still present. 
Lactose malabsorption is described in the second case. Milk intolerance is common in celiac and general population. It is generally quite well tolerated. Beside the patient noticed even before 
diagnosis increase of watery stool after milk assumption. It is good practice to limit milk intake during 
first weeks/months of GFD in particular when overt malabsortion is present. 
I would suggest the Authors to better describe the number od celiac disease patients they have 
seen, the diet the patients were on before diagnosis. 
I do not see the utility of figures. 
 Reject because scientifically unsound What next?: 
 An article of limited interest Level of interest: 
 Acceptable Quality of written English: 
 No Statistical review: 
Declaration of competing interests: 
none 
Please review this paper.
user
Reviewer's report 
 Partially Responsive Celiac Disease Resulting from Small Intestinal Bacterial Overgrowth and Title: 
Lactose Intolerance 
 2  14 January 2004 Version: Date: 
 carolina ciacci Reviewer: 
Reviewer's report: 
General 
The paper reports two cases of celiac disease with overt malabsorption syndrome. It is important that in Countries where celiac disease is considered uncommon the report of clinical cases of celiac disease. However, I have some concern about the concept that celiac disease may be considered 
partially responsive after only 40 days of GFD. In adults celiac disease may take months to recover 
despite strict GFD. SIBO can be a consequence of malabsorption as undigested food is a great pabulum for colon bacteria that may colonize ileum. It is unclear to me why tetracyclin had no effect in fist instance and full effect after 40 days when 
amalbsorpion is still present. 
Lactose malabsorption is described in the second case. Milk intolerance is common in celiac and general population. It is generally quite well tolerated. Beside the patient noticed even before 
diagnosis increase of watery stool after milk assumption. It is good practice to limit milk intake during 
first weeks/months of GFD in particular when overt malabsortion is present. 
I would suggest the Authors to better describe the number od celiac disease patients they have 
seen, the diet the patients were on before diagnosis. 
I do not see the utility of figures. 
 Reject because scientifically unsound What next?: 
 An article of limited interest Level of interest: 
 Acceptable Quality of written English: 
 No Statistical review: 
Declaration of competing interests: 
none 
assistant