Reviewer's report
Title:Small intestinal bacterial overgrowth mimicking acute flare as a pitfall in
patients with Crohn's Disease
Version: 1Date:11 March 2009
Reviewer: Mark Pimentel
Reviewer's report:
In this manuscript entitled "Small intestinal bacterial overgrowth mimcking acute
flare as a pitfall in patients with Crohn's dieseae", the authors describe that in
some circumstances, symptoms in Crohns may be related to bacterial
overgrowth as opposed to a flare of Crohns. This is a very important paper and is
well written.
The only major concern that I feel has not been adequately addressed is the
relationship between the abnormal breath test and the issue of intestinal
resection. The authors state that resection was a predictor of positive test. Is this
because resection leads to lack of ileocecal valve and overgrowth or is it due to
rapid transit from the resection and not overgrowth at all. I think this should at
least be discussed.
Did the authors exclude patients with adhesions or bowel obstruction? This could
also lead to mechanical issues leading to bacterial overgrowth.
In the results section (page 7) there is an extensive defense for using the glucose
breath test. This is too long. If the authors want to defend the use of glucose
breath test, they should do so in the discussion section of the paper. This is not
appropriate for the methods.
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests
Reviewer's report
Title:Small intestinal bacterial overgrowth mimicking acute flare as a pitfall in
patients with Crohn's Disease
Version: 1Date:11 March 2009
Reviewer: Mark Pimentel
Reviewer's report:
In this manuscript entitled "Small intestinal bacterial overgrowth mimcking acute
flare as a pitfall in patients with Crohn's dieseae", the authors describe that in
some circumstances, symptoms in Crohns may be related to bacterial
overgrowth as opposed to a flare of Crohns. This is a very important paper and is
well written.
The only major concern that I feel has not been adequately addressed is the
relationship between the abnormal breath test and the issue of intestinal
resection. The authors state that resection was a predictor of positive test. Is this
because resection leads to lack of ileocecal valve and overgrowth or is it due to
rapid transit from the resection and not overgrowth at all. I think this should at
least be discussed.
Did the authors exclude patients with adhesions or bowel obstruction? This could
also lead to mechanical issues leading to bacterial overgrowth.
In the results section (page 7) there is an extensive defense for using the glucose
breath test. This is too long. If the authors want to defend the use of glucose
breath test, they should do so in the discussion section of the paper. This is not
appropriate for the methods.
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests
Please review this paper.
user
Reviewer's report
Title:Small intestinal bacterial overgrowth mimicking acute flare as a pitfall in
patients with Crohn's Disease
Version: 1Date:11 March 2009
Reviewer: Mark Pimentel
Reviewer's report:
In this manuscript entitled "Small intestinal bacterial overgrowth mimcking acute
flare as a pitfall in patients with Crohn's dieseae", the authors describe that in
some circumstances, symptoms in Crohns may be related to bacterial
overgrowth as opposed to a flare of Crohns. This is a very important paper and is
well written.
The only major concern that I feel has not been adequately addressed is the
relationship between the abnormal breath test and the issue of intestinal
resection. The authors state that resection was a predictor of positive test. Is this
because resection leads to lack of ileocecal valve and overgrowth or is it due to
rapid transit from the resection and not overgrowth at all. I think this should at
least be discussed.
Did the authors exclude patients with adhesions or bowel obstruction? This could
also lead to mechanical issues leading to bacterial overgrowth.
In the results section (page 7) there is an extensive defense for using the glucose
breath test. This is too long. If the authors want to defend the use of glucose
breath test, they should do so in the discussion section of the paper. This is not
appropriate for the methods.
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests
assistant