Reviewer's report
Title:Low prevalence of 'classical' microscopic colitis but evidence of
microscopic inflammation in Asian patients with diarrhoea predominant irritable
bowel syndrome
Version: 2Date:3 November 2012
Reviewer: Greger Lindberg
Reviewer's report:
The authors have investigated the presence of microscopic colitis in Malaysian
patients with IBS-D in comparison with convenience controls (patients without
symptoms otherwise undergoing colonoscopy). They found that the prevalence
of 'classical' microscopic colitis was low both in patients and controls but that
patients exhibited an increased prevalence of unspecific colitis. In order to
determine the merits of this manuscript it is necessary to clarify some specific
items:
Major Compulsory Revisions
1. The title refers to 'classical' microscopic colitis and the authors state that this
was >20 IELs/100 epithelial cells "in conjunction with surface epithelial dmage".
Please give a reference to these criteria for 'classical' microscopic colitis.
2. The patient studied a consecutive series of patients who met the Rome-III
criteria for IBS-D but little or nothing is mentioned about selection factors for this
population. Had these patients been investigated at primary care level before
being referred? How many had undergone colonoscopy before coming to
UMMC? If none had had a colonoscopy before, this is vital information that
should be included in the manuscript. If a proportion of the patients had
undergone colonoscopy with biopsy before it may become necessary to divide
them into colonoscopy-naïve and previously endoscoped patients.
Minor Essential Revisions
3. In the discussion the authors discuss their findings in relation to those reported
by Falodia et al. According to the latter classification 12/74 patients in the present
study had microscopic colitis. This is somewhat confusing and I find it difficult to
make up my mind whether microscopic colitis was present or not in a significant
proportion of Malaysian patients with IBS-D.
4. The sentence "Three cases had involvement of the rectum, four cases had
involvement of the sigmoid or descending colon but in four cases inflammation
was seen only distal to the splenic flexure only" is difficult to understand. First,
there is more words only than needed, and secondly, I think it should be
"proximal" rather than "distal".
Level of interest: An article of importance in its field
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:Low prevalence of 'classical' microscopic colitis but evidence of
microscopic inflammation in Asian patients with diarrhoea predominant irritable
bowel syndrome
Version: 2Date:3 November 2012
Reviewer: Greger Lindberg
Reviewer's report:
The authors have investigated the presence of microscopic colitis in Malaysian
patients with IBS-D in comparison with convenience controls (patients without
symptoms otherwise undergoing colonoscopy). They found that the prevalence
of 'classical' microscopic colitis was low both in patients and controls but that
patients exhibited an increased prevalence of unspecific colitis. In order to
determine the merits of this manuscript it is necessary to clarify some specific
items:
Major Compulsory Revisions
1. The title refers to 'classical' microscopic colitis and the authors state that this
was >20 IELs/100 epithelial cells "in conjunction with surface epithelial dmage".
Please give a reference to these criteria for 'classical' microscopic colitis.
2. The patient studied a consecutive series of patients who met the Rome-III
criteria for IBS-D but little or nothing is mentioned about selection factors for this
population. Had these patients been investigated at primary care level before
being referred? How many had undergone colonoscopy before coming to
UMMC? If none had had a colonoscopy before, this is vital information that
should be included in the manuscript. If a proportion of the patients had
undergone colonoscopy with biopsy before it may become necessary to divide
them into colonoscopy-naïve and previously endoscoped patients.
Minor Essential Revisions
3. In the discussion the authors discuss their findings in relation to those reported
by Falodia et al. According to the latter classification 12/74 patients in the present
study had microscopic colitis. This is somewhat confusing and I find it difficult to
make up my mind whether microscopic colitis was present or not in a significant
proportion of Malaysian patients with IBS-D.
4. The sentence "Three cases had involvement of the rectum, four cases had
involvement of the sigmoid or descending colon but in four cases inflammation
was seen only distal to the splenic flexure only" is difficult to understand. First,
there is more words only than needed, and secondly, I think it should be
"proximal" rather than "distal".
Level of interest: An article of importance in its field
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:Low prevalence of 'classical' microscopic colitis but evidence of
microscopic inflammation in Asian patients with diarrhoea predominant irritable
bowel syndrome
Version: 2Date:3 November 2012
Reviewer: Greger Lindberg
Reviewer's report:
The authors have investigated the presence of microscopic colitis in Malaysian
patients with IBS-D in comparison with convenience controls (patients without
symptoms otherwise undergoing colonoscopy). They found that the prevalence
of 'classical' microscopic colitis was low both in patients and controls but that
patients exhibited an increased prevalence of unspecific colitis. In order to
determine the merits of this manuscript it is necessary to clarify some specific
items:
Major Compulsory Revisions
1. The title refers to 'classical' microscopic colitis and the authors state that this
was >20 IELs/100 epithelial cells "in conjunction with surface epithelial dmage".
Please give a reference to these criteria for 'classical' microscopic colitis.
2. The patient studied a consecutive series of patients who met the Rome-III
criteria for IBS-D but little or nothing is mentioned about selection factors for this
population. Had these patients been investigated at primary care level before
being referred? How many had undergone colonoscopy before coming to
UMMC? If none had had a colonoscopy before, this is vital information that
should be included in the manuscript. If a proportion of the patients had
undergone colonoscopy with biopsy before it may become necessary to divide
them into colonoscopy-naïve and previously endoscoped patients.
Minor Essential Revisions
3. In the discussion the authors discuss their findings in relation to those reported
by Falodia et al. According to the latter classification 12/74 patients in the present
study had microscopic colitis. This is somewhat confusing and I find it difficult to
make up my mind whether microscopic colitis was present or not in a significant
proportion of Malaysian patients with IBS-D.
4. The sentence "Three cases had involvement of the rectum, four cases had
involvement of the sigmoid or descending colon but in four cases inflammation
was seen only distal to the splenic flexure only" is difficult to understand. First,
there is more words only than needed, and secondly, I think it should be
"proximal" rather than "distal".
Level of interest: An article of importance in its field
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
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