Reviewer’s report
□
Treatment of achalasia: the short-term response to botulinum toxin injection is Title:
independent of any kind of pretreatment
Authors:
Martin Storr (martin.storr@lrz.tum.de )
Peter Born (p.born@lrz.tum.de )
Eckhard Frimberger (e.Frimberger@lrz.tum.de )
Norbert Weigert (n.weigert@lrz.tum.de )
Thomas Roesch (troesch@lrz.tum.de )
Alexander Meining (alex.meining@lrz.tum.de )
Meinhard Classen (m.classen@lrz.tum.de )
Hans Allescher (hans.allescher@lrz.tum.de )
15Jul 2002 Version: Date:
 Dr Guy boeckxstaens Reviewer:
Apaper whose findings are important to those with closely related Level of interest:
research interests
 Accept after discretionary revisions Advice on publication:
The authors have studied whether pretreatment has an effect on the outcome of 
botulinum toxin injection in patients with achalasia. The paper is well written and the 
data are nicely presented. 
1. I realize that it is difficult to collect large numbers of patients that have been 
treated earlier. Nevertheless, it should be stressed that the numbers in the pretreated groups is relatively small. Therefore, I believe that the conclusion (and the title) should be weakened. 
2. Although the outcome (symptom control) may be equal in the different groups, the 
authors should also compare the number of treatment sessions required to obtain 
this success rate. If patients pretreated require more injections than the untreated group, this may indicate an effect on the efficacy of botox injection. 
3. Page 7: What do the authors mean by "sum of the LESPs"? 
4. The mean LESP in patients pretreated was increased and similar to the untreated 
patients. Were there any patients who were treated and had symptoms, but had a 
normal or low LESP? If so, did they behave differently? 
Competing interests:None declared.
Reviewer’s report
□
Treatment of achalasia: the short-term response to botulinum toxin injection is Title:
independent of any kind of pretreatment
Authors:
Martin Storr (martin.storr@lrz.tum.de )
Peter Born (p.born@lrz.tum.de )
Eckhard Frimberger (e.Frimberger@lrz.tum.de )
Norbert Weigert (n.weigert@lrz.tum.de )
Thomas Roesch (troesch@lrz.tum.de )
Alexander Meining (alex.meining@lrz.tum.de )
Meinhard Classen (m.classen@lrz.tum.de )
Hans Allescher (hans.allescher@lrz.tum.de )
15Jul 2002 Version: Date:
 Dr Guy boeckxstaens Reviewer:
Apaper whose findings are important to those with closely related Level of interest:
research interests
 Accept after discretionary revisions Advice on publication:
The authors have studied whether pretreatment has an effect on the outcome of 
botulinum toxin injection in patients with achalasia. The paper is well written and the 
data are nicely presented. 
1. I realize that it is difficult to collect large numbers of patients that have been 
treated earlier. Nevertheless, it should be stressed that the numbers in the pretreated groups is relatively small. Therefore, I believe that the conclusion (and the title) should be weakened. 
2. Although the outcome (symptom control) may be equal in the different groups, the 
authors should also compare the number of treatment sessions required to obtain 
this success rate. If patients pretreated require more injections than the untreated group, this may indicate an effect on the efficacy of botox injection. 
3. Page 7: What do the authors mean by "sum of the LESPs"? 
4. The mean LESP in patients pretreated was increased and similar to the untreated 
patients. Were there any patients who were treated and had symptoms, but had a 
normal or low LESP? If so, did they behave differently? 
Competing interests:None declared.
Please review this paper.
user
Reviewer’s report
□
Treatment of achalasia: the short-term response to botulinum toxin injection is Title:
independent of any kind of pretreatment
Authors:
Martin Storr (martin.storr@lrz.tum.de )
Peter Born (p.born@lrz.tum.de )
Eckhard Frimberger (e.Frimberger@lrz.tum.de )
Norbert Weigert (n.weigert@lrz.tum.de )
Thomas Roesch (troesch@lrz.tum.de )
Alexander Meining (alex.meining@lrz.tum.de )
Meinhard Classen (m.classen@lrz.tum.de )
Hans Allescher (hans.allescher@lrz.tum.de )
15Jul 2002 Version: Date:
 Dr Guy boeckxstaens Reviewer:
Apaper whose findings are important to those with closely related Level of interest:
research interests
 Accept after discretionary revisions Advice on publication:
The authors have studied whether pretreatment has an effect on the outcome of 
botulinum toxin injection in patients with achalasia. The paper is well written and the 
data are nicely presented. 
1. I realize that it is difficult to collect large numbers of patients that have been 
treated earlier. Nevertheless, it should be stressed that the numbers in the pretreated groups is relatively small. Therefore, I believe that the conclusion (and the title) should be weakened. 
2. Although the outcome (symptom control) may be equal in the different groups, the 
authors should also compare the number of treatment sessions required to obtain 
this success rate. If patients pretreated require more injections than the untreated group, this may indicate an effect on the efficacy of botox injection. 
3. Page 7: What do the authors mean by "sum of the LESPs"? 
4. The mean LESP in patients pretreated was increased and similar to the untreated 
patients. Were there any patients who were treated and had symptoms, but had a 
normal or low LESP? If so, did they behave differently? 
Competing interests:None declared.
assistant