Reviewer ’s report  
Title:  Small intestinal bacterial overgrowth is associated with irritable bowel syndrome and is 
independent of proton pump inhibitor usage  
 
Version:  0 Date : 07 Sep 2015  
 
Reviewer:  Suneeta Krishnareddy  
 
Reviewer's report:  
1) in patients with diagnosed IBS, were other diagnosis considered and excluded, aside from 
diabetes related dysmotility, and scleroderma, were other causes of dysmotility ruled out, or 
other diseases associated with a higher inci dence of SIBO, such as celiac disease, IBD? The 
major issue is that IBS itself can predispose to motility issues and SIBO, and therefore render 
PPI usage unimportant in the development of SIBO. If a little more info is given on the 
background of these IBS patients, we might be able to extrapolate better in this patient 
population.  
2) slightly unclear in the methods, one PPI for the last one month, does this refer to one dose, or 
one type of PPI?  
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
Yes 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
Yes 
Are the conclusions drawn adequately supported by the data shown ? 
If not, please explain in your comments to the authors.  
No 
Are you able to assess any statistics in the manuscript or would you recommend an 
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects requi re further 
assessment in your comments to the editors.  
I am able to assess the statistics  
Quality of written English  
Please indicate the quality of language in the manuscript:  
Acceptable  
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
1. Have you in the past five years received reimbursements, f ees, funding, or salary from an 
organisation that may in any way gain or lose financial ly from the publication of this 
manuscript, either now or in the future?  
2. Do you hold any stocks or shares  in an organisation t hat may in any way gain or lose 
financially from the publication of this manuscript, either now or in the future?  
3. Do you hold or are you currently applying for any patents  relating to the content of the 
manuscript?  
4. Have you recei ved reimbursements, fees, funding, or salary from an organization that 
holds  or has applied for patents relating to the content of the manuscript?  
5. Do you have any other financial competing interests?  
6. Do you have any non -financial competing interests in relation to this paper?  
If you can answer no to all of the above, write 'I declare that I have no competing interests' 
below. If your reply is yes to any, please give details below.  
i have no competing interests  
I agree to the open peer review policy of the jou rnal. I understand that my name will be included 
on my report to the authors and, if the manuscript is accepted for publication, my named report 
including any attachments I upload will be posted on the website along with the authors' 
responses. I agree for  my report to be made available under an Open Access Creative Commons 
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments 
which I do not wish to be included in my named report can be included as confidential comments  
to the editors, which will not be published.  
I agree to the open peer review policy of the journal  
Reviewer ’s report  
Title:  Small intestinal bacterial overgrowth is associated with irritable bowel syndrome and is 
independent of proton pump inhibitor usage  
 
Version:  0 Date : 07 Sep 2015  
 
Reviewer:  Suneeta Krishnareddy  
 
Reviewer's report:  
1) in patients with diagnosed IBS, were other diagnosis considered and excluded, aside from 
diabetes related dysmotility, and scleroderma, were other causes of dysmotility ruled out, or 
other diseases associated with a higher inci dence of SIBO, such as celiac disease, IBD? The 
major issue is that IBS itself can predispose to motility issues and SIBO, and therefore render 
PPI usage unimportant in the development of SIBO. If a little more info is given on the 
background of these IBS patients, we might be able to extrapolate better in this patient 
population.  
2) slightly unclear in the methods, one PPI for the last one month, does this refer to one dose, or 
one type of PPI?  
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
Yes 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
Yes 
Are the conclusions drawn adequately supported by the data shown ? 
If not, please explain in your comments to the authors.  
No 
Are you able to assess any statistics in the manuscript or would you recommend an 
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects requi re further 
assessment in your comments to the editors.  
I am able to assess the statistics  
Quality of written English  
Please indicate the quality of language in the manuscript:  
Acceptable  
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
1. Have you in the past five years received reimbursements, f ees, funding, or salary from an 
organisation that may in any way gain or lose financial ly from the publication of this 
manuscript, either now or in the future?  
2. Do you hold any stocks or shares  in an organisation t hat may in any way gain or lose 
financially from the publication of this manuscript, either now or in the future?  
3. Do you hold or are you currently applying for any patents  relating to the content of the 
manuscript?  
4. Have you recei ved reimbursements, fees, funding, or salary from an organization that 
holds  or has applied for patents relating to the content of the manuscript?  
5. Do you have any other financial competing interests?  
6. Do you have any non -financial competing interests in relation to this paper?  
If you can answer no to all of the above, write 'I declare that I have no competing interests' 
below. If your reply is yes to any, please give details below.  
i have no competing interests  
I agree to the open peer review policy of the jou rnal. I understand that my name will be included 
on my report to the authors and, if the manuscript is accepted for publication, my named report 
including any attachments I upload will be posted on the website along with the authors' 
responses. I agree for  my report to be made available under an Open Access Creative Commons 
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments 
which I do not wish to be included in my named report can be included as confidential comments  
to the editors, which will not be published.  
I agree to the open peer review policy of the journal  
Please review this paper.
user
Reviewer ’s report  
Title:  Small intestinal bacterial overgrowth is associated with irritable bowel syndrome and is 
independent of proton pump inhibitor usage  
 
Version:  0 Date : 07 Sep 2015  
 
Reviewer:  Suneeta Krishnareddy  
 
Reviewer's report:  
1) in patients with diagnosed IBS, were other diagnosis considered and excluded, aside from 
diabetes related dysmotility, and scleroderma, were other causes of dysmotility ruled out, or 
other diseases associated with a higher inci dence of SIBO, such as celiac disease, IBD? The 
major issue is that IBS itself can predispose to motility issues and SIBO, and therefore render 
PPI usage unimportant in the development of SIBO. If a little more info is given on the 
background of these IBS patients, we might be able to extrapolate better in this patient 
population.  
2) slightly unclear in the methods, one PPI for the last one month, does this refer to one dose, or 
one type of PPI?  
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
Yes 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
Yes 
Are the conclusions drawn adequately supported by the data shown ? 
If not, please explain in your comments to the authors.  
No 
Are you able to assess any statistics in the manuscript or would you recommend an 
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects requi re further 
assessment in your comments to the editors.  
I am able to assess the statistics  
Quality of written English  
Please indicate the quality of language in the manuscript:  
Acceptable  
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
1. Have you in the past five years received reimbursements, f ees, funding, or salary from an 
organisation that may in any way gain or lose financial ly from the publication of this 
manuscript, either now or in the future?  
2. Do you hold any stocks or shares  in an organisation t hat may in any way gain or lose 
financially from the publication of this manuscript, either now or in the future?  
3. Do you hold or are you currently applying for any patents  relating to the content of the 
manuscript?  
4. Have you recei ved reimbursements, fees, funding, or salary from an organization that 
holds  or has applied for patents relating to the content of the manuscript?  
5. Do you have any other financial competing interests?  
6. Do you have any non -financial competing interests in relation to this paper?  
If you can answer no to all of the above, write 'I declare that I have no competing interests' 
below. If your reply is yes to any, please give details below.  
i have no competing interests  
I agree to the open peer review policy of the jou rnal. I understand that my name will be included 
on my report to the authors and, if the manuscript is accepted for publication, my named report 
including any attachments I upload will be posted on the website along with the authors' 
responses. I agree for  my report to be made available under an Open Access Creative Commons 
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments 
which I do not wish to be included in my named report can be included as confidential comments  
to the editors, which will not be published.  
I agree to the open peer review policy of the journal  
assistant