Title: The Effect of Benson Relaxation Technique on the Severity of Symptoms and Quality of
Life in Children with Irritable Bowel Syndrome (IBS): A Quasi-experimental Study
Version: 3 Date: 12 Jun 2022
Reviewer:  Christopher Radziwon
Reviewer's report:
BMC Gastroenterology
This is an extremely interesting manuscript investigating the possible benefits of brief relaxation
training on symptom severity and quality of life in children with irritable bowel syndrome. This
is a potentially beneficial non-drug treatment to help children manage a disorder that has a
significant disease burden on patient quality of life and distress.
Please consider the following comments and suggestions.
Comment & Suggestions
Background
Page 3,
Sentence beginning, “In Iran….”  Is there a citation for those prevalence rates?
Sentence beginning, “This syndrome, ….  The end of the sentence “has no specific diagnostic
symptoms…. Confusing sentence, please reword.
Sentence beginning “Evidence shows that …. Is there a citation?
Sentence beginning, “As a result…” Is there a citation?
Sentence beginning, “People can consciously…” Is there a citation?
Page 4
Participants
Fix Colon cancer
Please clarify if the participants were in-patient, out-patient, if they were released from the
hospital during treatment, etc. In the results please clarify if participants started out in-patient
and were released home during treatment. Was there an age difference for those children who
responded to treatment.
Please also clarify what might lead to a patient being an in-patient. Based on my experience in
the US, a patient would need to be very severe to be an in-patient for more than a few days.
Page 5
Outcome measures
Under the BSS-FS, it indicates the measure is for ibs with predominant symptoms of diarrhea.
What about those participants who struggle with constipation?
Page 7, fix age in table 1
Was there any difference between participants who were diarrhea versus constipation
predominant?
Page 8
Discussion
4th sentence, is “most cases” accurate?
Page 9
Sentence beginning, Non-pharmacological …” Is there a citation, is this correct?  Many
individuals who struggle seem to prefer medication as a simple fix.
Practice Implications
Do the authors have any other suggestions how the treatment could be used? It seems like an
effective, brief, and transferable treatment that can be taught and used in many settings. Such as
gastroenterologist outpatient clinics, primary care offices, and taught be nurses etc.
Page 10 Strengths & Weaknesses
The authors should emphasize that results should be interpreted with caution. It was not a true
experiment with blind randomization, much of the treatment seems like it was conducted in an
in-patient setting, where practice could be monitored and encouraged, etc.
Title: The Effect of Benson Relaxation Technique on the Severity of Symptoms and Quality of
Life in Children with Irritable Bowel Syndrome (IBS): A Quasi-experimental Study
Version: 3 Date: 12 Jun 2022
Reviewer:  Christopher Radziwon
Reviewer's report:
BMC Gastroenterology
This is an extremely interesting manuscript investigating the possible benefits of brief relaxation
training on symptom severity and quality of life in children with irritable bowel syndrome. This
is a potentially beneficial non-drug treatment to help children manage a disorder that has a
significant disease burden on patient quality of life and distress.
Please consider the following comments and suggestions.
Comment & Suggestions
Background
Page 3,
Sentence beginning, “In Iran….”  Is there a citation for those prevalence rates?
Sentence beginning, “This syndrome, ….  The end of the sentence “has no specific diagnostic
symptoms…. Confusing sentence, please reword.
Sentence beginning “Evidence shows that …. Is there a citation?
Sentence beginning, “As a result…” Is there a citation?
Sentence beginning, “People can consciously…” Is there a citation?
Page 4
Participants
Fix Colon cancer
Please clarify if the participants were in-patient, out-patient, if they were released from the
hospital during treatment, etc. In the results please clarify if participants started out in-patient
and were released home during treatment. Was there an age difference for those children who
responded to treatment.
Please also clarify what might lead to a patient being an in-patient. Based on my experience in
the US, a patient would need to be very severe to be an in-patient for more than a few days.
Page 5
Outcome measures
Under the BSS-FS, it indicates the measure is for ibs with predominant symptoms of diarrhea.
What about those participants who struggle with constipation?
Page 7, fix age in table 1
Was there any difference between participants who were diarrhea versus constipation
predominant?
Page 8
Discussion
4th sentence, is “most cases” accurate?
Page 9
Sentence beginning, Non-pharmacological …” Is there a citation, is this correct?  Many
individuals who struggle seem to prefer medication as a simple fix.
Practice Implications
Do the authors have any other suggestions how the treatment could be used? It seems like an
effective, brief, and transferable treatment that can be taught and used in many settings. Such as
gastroenterologist outpatient clinics, primary care offices, and taught be nurses etc.
Page 10 Strengths & Weaknesses
The authors should emphasize that results should be interpreted with caution. It was not a true
experiment with blind randomization, much of the treatment seems like it was conducted in an
in-patient setting, where practice could be monitored and encouraged, etc.
Please review this paper.
user
Title: The Effect of Benson Relaxation Technique on the Severity of Symptoms and Quality of
Life in Children with Irritable Bowel Syndrome (IBS): A Quasi-experimental Study
Version: 3 Date: 12 Jun 2022
Reviewer:  Christopher Radziwon
Reviewer's report:
BMC Gastroenterology
This is an extremely interesting manuscript investigating the possible benefits of brief relaxation
training on symptom severity and quality of life in children with irritable bowel syndrome. This
is a potentially beneficial non-drug treatment to help children manage a disorder that has a
significant disease burden on patient quality of life and distress.
Please consider the following comments and suggestions.
Comment & Suggestions
Background
Page 3,
Sentence beginning, “In Iran….”  Is there a citation for those prevalence rates?
Sentence beginning, “This syndrome, ….  The end of the sentence “has no specific diagnostic
symptoms…. Confusing sentence, please reword.
Sentence beginning “Evidence shows that …. Is there a citation?
Sentence beginning, “As a result…” Is there a citation?
Sentence beginning, “People can consciously…” Is there a citation?
Page 4
Participants
Fix Colon cancer
Please clarify if the participants were in-patient, out-patient, if they were released from the
hospital during treatment, etc. In the results please clarify if participants started out in-patient
and were released home during treatment. Was there an age difference for those children who
responded to treatment.
Please also clarify what might lead to a patient being an in-patient. Based on my experience in
the US, a patient would need to be very severe to be an in-patient for more than a few days.
Page 5
Outcome measures
Under the BSS-FS, it indicates the measure is for ibs with predominant symptoms of diarrhea.
What about those participants who struggle with constipation?
Page 7, fix age in table 1
Was there any difference between participants who were diarrhea versus constipation
predominant?
Page 8
Discussion
4th sentence, is “most cases” accurate?
Page 9
Sentence beginning, Non-pharmacological …” Is there a citation, is this correct?  Many
individuals who struggle seem to prefer medication as a simple fix.
Practice Implications
Do the authors have any other suggestions how the treatment could be used? It seems like an
effective, brief, and transferable treatment that can be taught and used in many settings. Such as
gastroenterologist outpatient clinics, primary care offices, and taught be nurses etc.
Page 10 Strengths & Weaknesses
The authors should emphasize that results should be interpreted with caution. It was not a true
experiment with blind randomization, much of the treatment seems like it was conducted in an
in-patient setting, where practice could be monitored and encouraged, etc.
assistant