Reviewer's report
Title:Postprandial fullness correlates with gastric barium excretion but not with
chronic gastritis.
Version: 2Date:18 November 2011
Reviewer: Greger Lindberg
Reviewer's report:
The authors have studied barium meal findings and their relation to reported
symptoms from a group of apparently healthy persons who have undergone a
routine medical check-up at a Japanese steel company. In order to understand
the merits of this study it is necessary to think a little about the experimental
set-up. Barium meal with a spasmolytic agent is presumably done to increase the
likelihood of detecting gastric cancer. This is how I interpret the multitude of
projections for the barium meal. I don't think that this technique has been applied
for the study of functional disturbances in the upper gut before. However, it does
allow the radiologist to determine with good sensitivity and specificity the
presence or absence of chronic gastritis (refs 9 & 10). The position of the head of
a barium meal is more difficult to interpret and I don't think there is data to show
that the head of barium has any clear relation with gastric emptying as assessed
by scintigraphy or breath testing. However, I think the position of the head of
barium during a barium meal examination might be an indicator of an underlying
mechanism that could be involved in the pathogenesis, or be an indicator of
post-prandial fullness. This is highly speculative but for example an
open-standing pylorus might represent a corresponding endoscopic finding or the
group with rapid filling of the duodenum could be similar to those with an early
rapid gastric emptying reported by Delgado-Aros et al. (ref 23). In all, I think this
study reports new information about a symptom that is quite common but still
puzzles us as to its underlying pathophysiology. If I were to give an advice to the
authors it would be to try to avoid mirroring their findings with findings from other
techniques, i.e. the head of the barium meal does not mirror gastric emptying at
least not that of solid food. I think this confuses the reader.
Now to the points raised by dr Sadik in his primary verdict on this manuscript.
#1. Not met, but the authors should not report the position of the head of barium
as a measure of gastric emptying, as long as the latter term has universal
acceptance for another finding using another technique.
#2 Adequately met (refs 9 & 10)
#3 Adequately met (builds on a validated questionnaire)
#4 Adequately explained, could be amended by informing the reader about the
reason for including barium meal using this technique in a routine medical
check-up.
#5 Adequately met.
Level of interest: An article whose findings are important to those with closely
related research interests
Reviewer's report
Title:Postprandial fullness correlates with gastric barium excretion but not with
chronic gastritis.
Version: 2Date:18 November 2011
Reviewer: Greger Lindberg
Reviewer's report:
The authors have studied barium meal findings and their relation to reported
symptoms from a group of apparently healthy persons who have undergone a
routine medical check-up at a Japanese steel company. In order to understand
the merits of this study it is necessary to think a little about the experimental
set-up. Barium meal with a spasmolytic agent is presumably done to increase the
likelihood of detecting gastric cancer. This is how I interpret the multitude of
projections for the barium meal. I don't think that this technique has been applied
for the study of functional disturbances in the upper gut before. However, it does
allow the radiologist to determine with good sensitivity and specificity the
presence or absence of chronic gastritis (refs 9 & 10). The position of the head of
a barium meal is more difficult to interpret and I don't think there is data to show
that the head of barium has any clear relation with gastric emptying as assessed
by scintigraphy or breath testing. However, I think the position of the head of
barium during a barium meal examination might be an indicator of an underlying
mechanism that could be involved in the pathogenesis, or be an indicator of
post-prandial fullness. This is highly speculative but for example an
open-standing pylorus might represent a corresponding endoscopic finding or the
group with rapid filling of the duodenum could be similar to those with an early
rapid gastric emptying reported by Delgado-Aros et al. (ref 23). In all, I think this
study reports new information about a symptom that is quite common but still
puzzles us as to its underlying pathophysiology. If I were to give an advice to the
authors it would be to try to avoid mirroring their findings with findings from other
techniques, i.e. the head of the barium meal does not mirror gastric emptying at
least not that of solid food. I think this confuses the reader.
Now to the points raised by dr Sadik in his primary verdict on this manuscript.
#1. Not met, but the authors should not report the position of the head of barium
as a measure of gastric emptying, as long as the latter term has universal
acceptance for another finding using another technique.
#2 Adequately met (refs 9 & 10)
#3 Adequately met (builds on a validated questionnaire)
#4 Adequately explained, could be amended by informing the reader about the
reason for including barium meal using this technique in a routine medical
check-up.
#5 Adequately met.
Level of interest: An article whose findings are important to those with closely
related research interests
Please review this paper.
user
Reviewer's report
Title:Postprandial fullness correlates with gastric barium excretion but not with
chronic gastritis.
Version: 2Date:18 November 2011
Reviewer: Greger Lindberg
Reviewer's report:
The authors have studied barium meal findings and their relation to reported
symptoms from a group of apparently healthy persons who have undergone a
routine medical check-up at a Japanese steel company. In order to understand
the merits of this study it is necessary to think a little about the experimental
set-up. Barium meal with a spasmolytic agent is presumably done to increase the
likelihood of detecting gastric cancer. This is how I interpret the multitude of
projections for the barium meal. I don't think that this technique has been applied
for the study of functional disturbances in the upper gut before. However, it does
allow the radiologist to determine with good sensitivity and specificity the
presence or absence of chronic gastritis (refs 9 & 10). The position of the head of
a barium meal is more difficult to interpret and I don't think there is data to show
that the head of barium has any clear relation with gastric emptying as assessed
by scintigraphy or breath testing. However, I think the position of the head of
barium during a barium meal examination might be an indicator of an underlying
mechanism that could be involved in the pathogenesis, or be an indicator of
post-prandial fullness. This is highly speculative but for example an
open-standing pylorus might represent a corresponding endoscopic finding or the
group with rapid filling of the duodenum could be similar to those with an early
rapid gastric emptying reported by Delgado-Aros et al. (ref 23). In all, I think this
study reports new information about a symptom that is quite common but still
puzzles us as to its underlying pathophysiology. If I were to give an advice to the
authors it would be to try to avoid mirroring their findings with findings from other
techniques, i.e. the head of the barium meal does not mirror gastric emptying at
least not that of solid food. I think this confuses the reader.
Now to the points raised by dr Sadik in his primary verdict on this manuscript.
#1. Not met, but the authors should not report the position of the head of barium
as a measure of gastric emptying, as long as the latter term has universal
acceptance for another finding using another technique.
#2 Adequately met (refs 9 & 10)
#3 Adequately met (builds on a validated questionnaire)
#4 Adequately explained, could be amended by informing the reader about the
reason for including barium meal using this technique in a routine medical
check-up.
#5 Adequately met.
Level of interest: An article whose findings are important to those with closely
related research interests
assistant