Title: Mucosal healing of small intestinal stricture is associated with improved prognosis post-
dilation in Crohn’s disease
Version: 1 Date: 18 Mar 2022
Reviewer's report:
Hibiya et al present a very interesting and useful retrospective analysis of mucosal healing of
small bowel strictures and its relationship to the success of balloon dilation.  Overall this is a
well designed study and the paper is well written.  Specific comments below:
1.  It is not clear from the abstract that this paper specifically refers to strictures ABOVE the
terminal ileum - i.e. requiring access via balloon enteroscopy.  As many CD strictures occur
in the terminal ileum and ICV, it must be very clear that this paper refers to strictures NOT
accessible via standard colonoscopy.  In the methods section this also must be clarified if patients
with terminal ileal strictures were specifically excluded.
2.  Background - "The development of balloon-assisted enteroscopy (BAE)2 has made
endoscopic balloon dilation (EBD) of small intestinal strictures possible, consequently avoiding
surgery3,4. " <-- this is not strictly true that all EBD avoids surgery.  I suggest rewording this.
3.  Results - "Patient's Background" would be better referred to as Demographics.
Most results presented in this section are reported without P values in the text (although well
reported in the accompanying tables.  I would suggest adding the P values in the text to assist
the reader in discerning the  significant results and level of significance.  Likewise, a P Value
for the difference in the survival (HR and P Val) would add to figure 2.
There is no reporting  any analysis of medication or treatment or overall disease duration other
than what is presented in the tables.  It would be interesting to analyse patients on combination
therapy (Immunomodulator + anti-TNF)  separately as well as duration of anti-TNF therapy (i.e.
how long before the EBD was this commenced?).  This should be discussed in the discussion
section as a recently published stricture trial (Schulberg et al, Lancet Gastro Hep, 2022) has
shown a benefit in anti-TNF treatment on the outcomes of strictures.
4. Discussion
The discussion contains a number of statements that should be in the results section rather than
the discussion (transition to surgery rates, strictures >2cm etc).
Also, minor spelling mistakes noted in the tables.
Title: Mucosal healing of small intestinal stricture is associated with improved prognosis post-
dilation in Crohn’s disease
Version: 1 Date: 18 Mar 2022
Reviewer's report:
Hibiya et al present a very interesting and useful retrospective analysis of mucosal healing of
small bowel strictures and its relationship to the success of balloon dilation.  Overall this is a
well designed study and the paper is well written.  Specific comments below:
1.  It is not clear from the abstract that this paper specifically refers to strictures ABOVE the
terminal ileum - i.e. requiring access via balloon enteroscopy.  As many CD strictures occur
in the terminal ileum and ICV, it must be very clear that this paper refers to strictures NOT
accessible via standard colonoscopy.  In the methods section this also must be clarified if patients
with terminal ileal strictures were specifically excluded.
2.  Background - "The development of balloon-assisted enteroscopy (BAE)2 has made
endoscopic balloon dilation (EBD) of small intestinal strictures possible, consequently avoiding
surgery3,4. " <-- this is not strictly true that all EBD avoids surgery.  I suggest rewording this.
3.  Results - "Patient's Background" would be better referred to as Demographics.
Most results presented in this section are reported without P values in the text (although well
reported in the accompanying tables.  I would suggest adding the P values in the text to assist
the reader in discerning the  significant results and level of significance.  Likewise, a P Value
for the difference in the survival (HR and P Val) would add to figure 2.
There is no reporting  any analysis of medication or treatment or overall disease duration other
than what is presented in the tables.  It would be interesting to analyse patients on combination
therapy (Immunomodulator + anti-TNF)  separately as well as duration of anti-TNF therapy (i.e.
how long before the EBD was this commenced?).  This should be discussed in the discussion
section as a recently published stricture trial (Schulberg et al, Lancet Gastro Hep, 2022) has
shown a benefit in anti-TNF treatment on the outcomes of strictures.
4. Discussion
The discussion contains a number of statements that should be in the results section rather than
the discussion (transition to surgery rates, strictures >2cm etc).
Also, minor spelling mistakes noted in the tables.
Please review this paper.
user
Title: Mucosal healing of small intestinal stricture is associated with improved prognosis post-
dilation in Crohn’s disease
Version: 1 Date: 18 Mar 2022
Reviewer's report:
Hibiya et al present a very interesting and useful retrospective analysis of mucosal healing of
small bowel strictures and its relationship to the success of balloon dilation.  Overall this is a
well designed study and the paper is well written.  Specific comments below:
1.  It is not clear from the abstract that this paper specifically refers to strictures ABOVE the
terminal ileum - i.e. requiring access via balloon enteroscopy.  As many CD strictures occur
in the terminal ileum and ICV, it must be very clear that this paper refers to strictures NOT
accessible via standard colonoscopy.  In the methods section this also must be clarified if patients
with terminal ileal strictures were specifically excluded.
2.  Background - "The development of balloon-assisted enteroscopy (BAE)2 has made
endoscopic balloon dilation (EBD) of small intestinal strictures possible, consequently avoiding
surgery3,4. " <-- this is not strictly true that all EBD avoids surgery.  I suggest rewording this.
3.  Results - "Patient's Background" would be better referred to as Demographics.
Most results presented in this section are reported without P values in the text (although well
reported in the accompanying tables.  I would suggest adding the P values in the text to assist
the reader in discerning the  significant results and level of significance.  Likewise, a P Value
for the difference in the survival (HR and P Val) would add to figure 2.
There is no reporting  any analysis of medication or treatment or overall disease duration other
than what is presented in the tables.  It would be interesting to analyse patients on combination
therapy (Immunomodulator + anti-TNF)  separately as well as duration of anti-TNF therapy (i.e.
how long before the EBD was this commenced?).  This should be discussed in the discussion
section as a recently published stricture trial (Schulberg et al, Lancet Gastro Hep, 2022) has
shown a benefit in anti-TNF treatment on the outcomes of strictures.
4. Discussion
The discussion contains a number of statements that should be in the results section rather than
the discussion (transition to surgery rates, strictures >2cm etc).
Also, minor spelling mistakes noted in the tables.
assistant