Reviewer's report
Title:Development of functional gastrointestinal disorders after Giardia lamblia
infection
Version: 1Date:5 January 2009
Reviewer: Giovanni Barbara
Reviewer's report:
Post-infectious functional gastrointestinal syndromes, and particularly irritable
bowel syndrome have been mainly investigated following acute bacterial
gastroenteritis. The present study is of interest since it addresses the possibility
that the non-invasive protozoan Giardia lamblia is involved in the development of
long-lasting post-infectious functional symptoms after eradication.
The method used to identify successful eradication has some limitations since
micrioscopy of fecal samples has a sensitivity around 85%. This should be
acknowledged in the manuscript.
Although this is a prospective study the presence/absence of symptoms before
the infection was assessed retrospectively. This is a limitation since it appears
that many patients were asked about their previous symptoms a long time after
the diagnosis of Giardia infection. This may generate a recall bias.
The study is uncontrolled and this may overestimate the prevalence of
symptoms. What is the prevalence of FGID in age, gender and region matched
controls?
Could be the authors more precise on the tests they did on the patients to
exclude other diseases? Did they exclude celiac disease or major food allergies?
Reviewer's report
Title:Development of functional gastrointestinal disorders after Giardia lamblia
infection
Version: 1Date:5 January 2009
Reviewer: Giovanni Barbara
Reviewer's report:
Post-infectious functional gastrointestinal syndromes, and particularly irritable
bowel syndrome have been mainly investigated following acute bacterial
gastroenteritis. The present study is of interest since it addresses the possibility
that the non-invasive protozoan Giardia lamblia is involved in the development of
long-lasting post-infectious functional symptoms after eradication.
The method used to identify successful eradication has some limitations since
micrioscopy of fecal samples has a sensitivity around 85%. This should be
acknowledged in the manuscript.
Although this is a prospective study the presence/absence of symptoms before
the infection was assessed retrospectively. This is a limitation since it appears
that many patients were asked about their previous symptoms a long time after
the diagnosis of Giardia infection. This may generate a recall bias.
The study is uncontrolled and this may overestimate the prevalence of
symptoms. What is the prevalence of FGID in age, gender and region matched
controls?
Could be the authors more precise on the tests they did on the patients to
exclude other diseases? Did they exclude celiac disease or major food allergies?
Please review this paper.
user
Reviewer's report
Title:Development of functional gastrointestinal disorders after Giardia lamblia
infection
Version: 1Date:5 January 2009
Reviewer: Giovanni Barbara
Reviewer's report:
Post-infectious functional gastrointestinal syndromes, and particularly irritable
bowel syndrome have been mainly investigated following acute bacterial
gastroenteritis. The present study is of interest since it addresses the possibility
that the non-invasive protozoan Giardia lamblia is involved in the development of
long-lasting post-infectious functional symptoms after eradication.
The method used to identify successful eradication has some limitations since
micrioscopy of fecal samples has a sensitivity around 85%. This should be
acknowledged in the manuscript.
Although this is a prospective study the presence/absence of symptoms before
the infection was assessed retrospectively. This is a limitation since it appears
that many patients were asked about their previous symptoms a long time after
the diagnosis of Giardia infection. This may generate a recall bias.
The study is uncontrolled and this may overestimate the prevalence of
symptoms. What is the prevalence of FGID in age, gender and region matched
controls?
Could be the authors more precise on the tests they did on the patients to
exclude other diseases? Did they exclude celiac disease or major food allergies?
assistant