Title: Influence of the Examination Position and Distension Medium on the Rectal Sensory Test
in Patients with Functional Constipation
Version: 1 Date: 26 May 2024
Reviewer's report:
Thank you for the opportunity to revise the manuscript ”Influence of the Examination Position
and Distension Medium on the Rectal Sensory Test in Patients with Functional Constipation”.
The manuscript by Xiao et al describe the impact of body position and distension medium on
rectal sensory test in 39 patients with functional constipation.
It is an interesting study but I feel that the manuscript needs more work before it can be published.
My comments are as follows:
Method section:
I have several questions about the method. Did all the participants start with the same body
position and distension medium? I lack information about the about CSS, PAC-SYM and PAC-
Qol that are presented in the result section.
In addition I lack information about the testing of rectal resting pressure, anal resting pressure,
functional anal canal length, and maximum anal squeeze pressure.
I would like clarification with regards to the 2nd exclusion criteria, what do you mean my “etc.”?
Can you please specify which conditions were excluded.
Why did you use fasting blood sugar >7.8 mmol/L as an exclusion criteria? This will only give
you a snapshot of the blood sugar control. Why didn’t you use glycated haemoglobin (HbA1c)?
Page 4, line 77: which other parameters are you referring to? Do you refer to body position and
distension method or some other parameters?
Exclusion criteria: I find that point 1, 2 and 3 largely address the same issue. I suggest you
rewrite these points to clarify for the readers.
Why did you stop the inflation already at 180 ml? I find this to be a quite low maximum tolerated
volume and this need to be discussed.
Result section:
To help the reader to understand your results better I would suggest that you explain your
correlations.
You state that the rectal and anal pressures in the left lateral positions all were within in your
labs normal range. What is your labs normal values?
If I understand correctly, the only significant difference was DDV between water or gas was in
squatting? I think this result should be highlighted better in this paragraph. You make several
comparisons and sometimes it is hard for the reader to follow.
Discussion section:
The text in these paragraphs are interesting but in several of the paragraphs you do not discuss
your results and the text would be better placed in the background.
What is the clinical implications for test set-up?
Furthermore, are there any limitations of this study? In the discussion, the limitations of this
study should be stated.
Title: Influence of the Examination Position and Distension Medium on the Rectal Sensory Test
in Patients with Functional Constipation
Version: 1 Date: 26 May 2024
Reviewer's report:
Thank you for the opportunity to revise the manuscript ”Influence of the Examination Position
and Distension Medium on the Rectal Sensory Test in Patients with Functional Constipation”.
The manuscript by Xiao et al describe the impact of body position and distension medium on
rectal sensory test in 39 patients with functional constipation.
It is an interesting study but I feel that the manuscript needs more work before it can be published.
My comments are as follows:
Method section:
I have several questions about the method. Did all the participants start with the same body
position and distension medium? I lack information about the about CSS, PAC-SYM and PAC-
Qol that are presented in the result section.
In addition I lack information about the testing of rectal resting pressure, anal resting pressure,
functional anal canal length, and maximum anal squeeze pressure.
I would like clarification with regards to the 2nd exclusion criteria, what do you mean my “etc.”?
Can you please specify which conditions were excluded.
Why did you use fasting blood sugar >7.8 mmol/L as an exclusion criteria? This will only give
you a snapshot of the blood sugar control. Why didn’t you use glycated haemoglobin (HbA1c)?
Page 4, line 77: which other parameters are you referring to? Do you refer to body position and
distension method or some other parameters?
Exclusion criteria: I find that point 1, 2 and 3 largely address the same issue. I suggest you
rewrite these points to clarify for the readers.
Why did you stop the inflation already at 180 ml? I find this to be a quite low maximum tolerated
volume and this need to be discussed.
Result section:
To help the reader to understand your results better I would suggest that you explain your
correlations.
You state that the rectal and anal pressures in the left lateral positions all were within in your
labs normal range. What is your labs normal values?
If I understand correctly, the only significant difference was DDV between water or gas was in
squatting? I think this result should be highlighted better in this paragraph. You make several
comparisons and sometimes it is hard for the reader to follow.
Discussion section:
The text in these paragraphs are interesting but in several of the paragraphs you do not discuss
your results and the text would be better placed in the background.
What is the clinical implications for test set-up?
Furthermore, are there any limitations of this study? In the discussion, the limitations of this
study should be stated.
Please review this paper.
user
Title: Influence of the Examination Position and Distension Medium on the Rectal Sensory Test
in Patients with Functional Constipation
Version: 1 Date: 26 May 2024
Reviewer's report:
Thank you for the opportunity to revise the manuscript ”Influence of the Examination Position
and Distension Medium on the Rectal Sensory Test in Patients with Functional Constipation”.
The manuscript by Xiao et al describe the impact of body position and distension medium on
rectal sensory test in 39 patients with functional constipation.
It is an interesting study but I feel that the manuscript needs more work before it can be published.
My comments are as follows:
Method section:
I have several questions about the method. Did all the participants start with the same body
position and distension medium? I lack information about the about CSS, PAC-SYM and PAC-
Qol that are presented in the result section.
In addition I lack information about the testing of rectal resting pressure, anal resting pressure,
functional anal canal length, and maximum anal squeeze pressure.
I would like clarification with regards to the 2nd exclusion criteria, what do you mean my “etc.”?
Can you please specify which conditions were excluded.
Why did you use fasting blood sugar >7.8 mmol/L as an exclusion criteria? This will only give
you a snapshot of the blood sugar control. Why didn’t you use glycated haemoglobin (HbA1c)?
Page 4, line 77: which other parameters are you referring to? Do you refer to body position and
distension method or some other parameters?
Exclusion criteria: I find that point 1, 2 and 3 largely address the same issue. I suggest you
rewrite these points to clarify for the readers.
Why did you stop the inflation already at 180 ml? I find this to be a quite low maximum tolerated
volume and this need to be discussed.
Result section:
To help the reader to understand your results better I would suggest that you explain your
correlations.
You state that the rectal and anal pressures in the left lateral positions all were within in your
labs normal range. What is your labs normal values?
If I understand correctly, the only significant difference was DDV between water or gas was in
squatting? I think this result should be highlighted better in this paragraph. You make several
comparisons and sometimes it is hard for the reader to follow.
Discussion section:
The text in these paragraphs are interesting but in several of the paragraphs you do not discuss
your results and the text would be better placed in the background.
What is the clinical implications for test set-up?
Furthermore, are there any limitations of this study? In the discussion, the limitations of this
study should be stated.
assistant