Title: Discrete terminal ileal ulcers in patients diagnosed with ulcerative colitis: clinical
significance and natural course
Version: 1 Date: 28 Apr 2021
Reviewer:  Hans Strid
Reviewer's report:
General Comments to the Authors
The main objective of this retrospective study was to assess the frequency of ulcers in terminal
ileum in patients with ulcerative colitis (UC). The authors also wanted to evaluate the clinical
consequences of these ulcers. 397 patients with UC and successful intubation of terminal
ileum were found and 41 (10.3%) showed TI ulcers. There was no difference in the clinical
characteristic (baseline data, disease activity, endoscopic score, and so on) between patients with
and without TI ulcers. In 30 of the 41 patients, a follow-up colonoscopy was performed and in
a majority (77%) the ulcers were resolved.
The data of the study are rather novel. However, the retrospective design of the study is a
drawback and makes the results unreliable.
Specific Comments to the Authors
Abstract
No comments
Introduction
No comments.
Methods
There are no evaluation of NSAID use which is a weakness of the study. This has already been
stated by the authors.
In most of patients with ulcers in the terminal ileum, assessment of the small intestine should be
performed. It would strengthen the manuscript if information of MRI and/or capsule endoscopy
assessment is available.
There are no control group of patients without UC (IBD) undergoing colonoscopy in the study.
Results
The result part is generally somewhat thin (few results)
Discussion
In the Discussion, the authors stated that TI ulcers were more common in patients with UC
compared with patients without UC. However, as mentioned before a control group is lacking.
Title: Discrete terminal ileal ulcers in patients diagnosed with ulcerative colitis: clinical
significance and natural course
Version: 1 Date: 28 Apr 2021
Reviewer:  Hans Strid
Reviewer's report:
General Comments to the Authors
The main objective of this retrospective study was to assess the frequency of ulcers in terminal
ileum in patients with ulcerative colitis (UC). The authors also wanted to evaluate the clinical
consequences of these ulcers. 397 patients with UC and successful intubation of terminal
ileum were found and 41 (10.3%) showed TI ulcers. There was no difference in the clinical
characteristic (baseline data, disease activity, endoscopic score, and so on) between patients with
and without TI ulcers. In 30 of the 41 patients, a follow-up colonoscopy was performed and in
a majority (77%) the ulcers were resolved.
The data of the study are rather novel. However, the retrospective design of the study is a
drawback and makes the results unreliable.
Specific Comments to the Authors
Abstract
No comments
Introduction
No comments.
Methods
There are no evaluation of NSAID use which is a weakness of the study. This has already been
stated by the authors.
In most of patients with ulcers in the terminal ileum, assessment of the small intestine should be
performed. It would strengthen the manuscript if information of MRI and/or capsule endoscopy
assessment is available.
There are no control group of patients without UC (IBD) undergoing colonoscopy in the study.
Results
The result part is generally somewhat thin (few results)
Discussion
In the Discussion, the authors stated that TI ulcers were more common in patients with UC
compared with patients without UC. However, as mentioned before a control group is lacking.
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:  Hans Strid
Reviewer's report:
General Comments to the Authors
The main objective of this retrospective study was to assess the frequency of ulcers in terminal
ileum in patients with ulcerative colitis (UC). The authors also wanted to evaluate the clinical
consequences of these ulcers. 397 patients with UC and successful intubation of terminal
ileum were found and 41 (10.3%) showed TI ulcers. There was no difference in the clinical
characteristic (baseline data, disease activity, endoscopic score, and so on) between patients with
and without TI ulcers. In 30 of the 41 patients, a follow-up colonoscopy was performed and in
a majority (77%) the ulcers were resolved.
The data of the study are rather novel. However, the retrospective design of the study is a
drawback and makes the results unreliable.
Specific Comments to the Authors
Abstract
No comments
Introduction
No comments.
Methods
There are no evaluation of NSAID use which is a weakness of the study. This has already been
stated by the authors.
In most of patients with ulcers in the terminal ileum, assessment of the small intestine should be
performed. It would strengthen the manuscript if information of MRI and/or capsule endoscopy
assessment is available.
There are no control group of patients without UC (IBD) undergoing colonoscopy in the study.
Results
The result part is generally somewhat thin (few results)
Discussion
In the Discussion, the authors stated that TI ulcers were more common in patients with UC
compared with patients without UC. However, as mentioned before a control group is lacking.
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