Reviewer's report
Title:Small intestinal bacterial overgrowth mimicking acute flare as a pitfall in
patients with Crohn's Disease
Version: 1Date:15 March 2009
Reviewer: Christel Neut
Reviewer's report:
This is an interesting clinical paper on SIBO in CD patients. This complication is
underdiagnosized in CD but can have important clinical consequences.It can be
favored by surgery. Suppression of the ileocecal valve can fovor entrance of
colonic bacteria in the small bowel.
1-Minor essential revisions
The title should be changed and indicate that SIBO is a complication of CD
associated to flare up of disease. In patients with a high CDAI it seems difficult to
consider SIBO as a secondary event.
2-Minor essential revisions
The introduction should clearly state that the method used id indirect and will only
detect hydrogen produced by some (not all) anaerobic bacteria. SIBO is possible
without hydrogen formation.Glucose is used as external substrate for these
bacteria. Lactulose woul be a better substrate because not resorbed by the small
intestine and only used by bacteria. In SIBO, lactulose can be used as a
substrate. In absence of SIBO, it is used to establish orocecal transit time.
3-Minor essential revisions
The used HGBT method should be justified in the introduction section and not in
the methodology section (page 7 and 8).
4-Minor essential revisions
Antibiotherapy is evoked in the introduction and discussion but not used for the
studied population. It should be discussed that an antibiotic treatment will not
show a long-lasting effect because the anatomic disorders remain present and
will allow recurrence.
5-Minor essential revisions
The references cited need revisions to use always the same type of citations.
Names of journals are sometimes complete and sometimes shortened. Ref 4
"Auflage" should be changed to "edition"
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Needs some language corrections before being
published
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:15 March 2009
Reviewer: Christel Neut
Reviewer's report:
This is an interesting clinical paper on SIBO in CD patients. This complication is
underdiagnosized in CD but can have important clinical consequences.It can be
favored by surgery. Suppression of the ileocecal valve can fovor entrance of
colonic bacteria in the small bowel.
1-Minor essential revisions
The title should be changed and indicate that SIBO is a complication of CD
associated to flare up of disease. In patients with a high CDAI it seems difficult to
consider SIBO as a secondary event.
2-Minor essential revisions
The introduction should clearly state that the method used id indirect and will only
detect hydrogen produced by some (not all) anaerobic bacteria. SIBO is possible
without hydrogen formation.Glucose is used as external substrate for these
bacteria. Lactulose woul be a better substrate because not resorbed by the small
intestine and only used by bacteria. In SIBO, lactulose can be used as a
substrate. In absence of SIBO, it is used to establish orocecal transit time.
3-Minor essential revisions
The used HGBT method should be justified in the introduction section and not in
the methodology section (page 7 and 8).
4-Minor essential revisions
Antibiotherapy is evoked in the introduction and discussion but not used for the
studied population. It should be discussed that an antibiotic treatment will not
show a long-lasting effect because the anatomic disorders remain present and
will allow recurrence.
5-Minor essential revisions
The references cited need revisions to use always the same type of citations.
Names of journals are sometimes complete and sometimes shortened. Ref 4
"Auflage" should be changed to "edition"
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Needs some language corrections before being
published
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:15 March 2009
Reviewer: Christel Neut
Reviewer's report:
This is an interesting clinical paper on SIBO in CD patients. This complication is
underdiagnosized in CD but can have important clinical consequences.It can be
favored by surgery. Suppression of the ileocecal valve can fovor entrance of
colonic bacteria in the small bowel.
1-Minor essential revisions
The title should be changed and indicate that SIBO is a complication of CD
associated to flare up of disease. In patients with a high CDAI it seems difficult to
consider SIBO as a secondary event.
2-Minor essential revisions
The introduction should clearly state that the method used id indirect and will only
detect hydrogen produced by some (not all) anaerobic bacteria. SIBO is possible
without hydrogen formation.Glucose is used as external substrate for these
bacteria. Lactulose woul be a better substrate because not resorbed by the small
intestine and only used by bacteria. In SIBO, lactulose can be used as a
substrate. In absence of SIBO, it is used to establish orocecal transit time.
3-Minor essential revisions
The used HGBT method should be justified in the introduction section and not in
the methodology section (page 7 and 8).
4-Minor essential revisions
Antibiotherapy is evoked in the introduction and discussion but not used for the
studied population. It should be discussed that an antibiotic treatment will not
show a long-lasting effect because the anatomic disorders remain present and
will allow recurrence.
5-Minor essential revisions
The references cited need revisions to use always the same type of citations.
Names of journals are sometimes complete and sometimes shortened. Ref 4
"Auflage" should be changed to "edition"
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Needs some language corrections before being
published
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