Title: Discrete terminal ileal ulcers in patients diagnosed with ulcerative colitis: clinical
significance and natural course
Version: 1 Date: 28 Apr 2021
Reviewer's report:
This is an observational study that retrospectively examined the clinical features of non-specific
small ulcers at terminal ileum that are often observed in patients with ulcerative colitis. In this
study, the etiology of this terminal ileal ulcers and its significance in ulcerative colitis remain
unclear, but its clinical features have been clarified by detailed examination. That is, although
this ulcer is more frequently observed in ulcerative colitis than in asymptomatic patients, it is
less related to the clinical course and long-term prognosis of ulcerative colitis, and it shows a
high rate of self-limiting cure.  This fact is also considered to be meaningful in the medical care
of ulcerative colitis. Based on the above, we believe that this paper is suitable for publication,
but we believe that the following points need to be corrected and added.
Minor point:
(1) It is necessary to show a typical histopathological image of the terminal ileal ulcer.
(2) It is desirable to show if the dose rate of NSAIDs and antibiotics is known when colonoscopy
confirms terminal ileal ulcer.
(3) Were additional tests performed for the purpose of investigating the cause of ulcers for which
self-limiting cure was not confirmed by follow-up?  If there are cases in which the etiology of
the ulcer has been identified, these should be presented.
(4) If there are cases in which upper endoscopy or capsule endoscopy is performed during the
follow-up period after the detection of terminal ileal ulcer, it is desirable to add the results as
well.
Title: Discrete terminal ileal ulcers in patients diagnosed with ulcerative colitis: clinical
significance and natural course
Version: 1 Date: 28 Apr 2021
Reviewer's report:
This is an observational study that retrospectively examined the clinical features of non-specific
small ulcers at terminal ileum that are often observed in patients with ulcerative colitis. In this
study, the etiology of this terminal ileal ulcers and its significance in ulcerative colitis remain
unclear, but its clinical features have been clarified by detailed examination. That is, although
this ulcer is more frequently observed in ulcerative colitis than in asymptomatic patients, it is
less related to the clinical course and long-term prognosis of ulcerative colitis, and it shows a
high rate of self-limiting cure.  This fact is also considered to be meaningful in the medical care
of ulcerative colitis. Based on the above, we believe that this paper is suitable for publication,
but we believe that the following points need to be corrected and added.
Minor point:
(1) It is necessary to show a typical histopathological image of the terminal ileal ulcer.
(2) It is desirable to show if the dose rate of NSAIDs and antibiotics is known when colonoscopy
confirms terminal ileal ulcer.
(3) Were additional tests performed for the purpose of investigating the cause of ulcers for which
self-limiting cure was not confirmed by follow-up?  If there are cases in which the etiology of
the ulcer has been identified, these should be presented.
(4) If there are cases in which upper endoscopy or capsule endoscopy is performed during the
follow-up period after the detection of terminal ileal ulcer, it is desirable to add the results as
well.
Please review this paper.
user
Title: Discrete terminal ileal ulcers in patients diagnosed with ulcerative colitis: clinical
significance and natural course
Version: 1 Date: 28 Apr 2021
Reviewer's report:
This is an observational study that retrospectively examined the clinical features of non-specific
small ulcers at terminal ileum that are often observed in patients with ulcerative colitis. In this
study, the etiology of this terminal ileal ulcers and its significance in ulcerative colitis remain
unclear, but its clinical features have been clarified by detailed examination. That is, although
this ulcer is more frequently observed in ulcerative colitis than in asymptomatic patients, it is
less related to the clinical course and long-term prognosis of ulcerative colitis, and it shows a
high rate of self-limiting cure.  This fact is also considered to be meaningful in the medical care
of ulcerative colitis. Based on the above, we believe that this paper is suitable for publication,
but we believe that the following points need to be corrected and added.
Minor point:
(1) It is necessary to show a typical histopathological image of the terminal ileal ulcer.
(2) It is desirable to show if the dose rate of NSAIDs and antibiotics is known when colonoscopy
confirms terminal ileal ulcer.
(3) Were additional tests performed for the purpose of investigating the cause of ulcers for which
self-limiting cure was not confirmed by follow-up?  If there are cases in which the etiology of
the ulcer has been identified, these should be presented.
(4) If there are cases in which upper endoscopy or capsule endoscopy is performed during the
follow-up period after the detection of terminal ileal ulcer, it is desirable to add the results as
well.
assistant