Reviewer's report
Title:The Frequency Of Microscopic And Focal Active Colitis In Patients With
Irritable Bowel Syndrome
Version: 2Date:25 May 2011
Reviewer: Joel H Rubenstein
Reviewer's report:
The authors have conducted a cross-sectional case-control study estimating the
association of symptoms of IBS with microscopic colitis, finding that it is found in
3% of IBS patients, and 4.3% of non-constipated IBS patients. They also report a
substantial minority of IBS patients with focal active colitis.
Major concerns:
1) The average age of the IBS patients was 46, which seems higher than in most
studies, and might explain the relatively high proportion found to have MC. What
were the ages of the IBS patients found to have MC? Table I suggests that
patients greater than age 50 with IBS symptoms were excluded – is this not the
case?
2) Was the terminal ileum intubated routinely to exclude crohn’s ileitis?
3) 2nd to last paragraph of results: “biopsy samples were taken … to ascertain
that there was no pathology present in the controls.” - were controls excluded if
they have abnormal pathology? If so, this would be an error, as the comparison
of prevalence of MC or focal colitis would be biased by selection.
4) Were no patients found to have collagenous colitis?
Minor suggestions:
1) The classification of Groups I, II, and III are not well known and cumbersome
for the reader. The authors might change this to IBS-C, IBS-D, and IBS-M
(constipation, diarrhea, mixed).
2) Results first paragraph states that the average age of both groups was
identical, which contradicts Table 2 and later in the paragraph.
3) Discussion first paragraph omits reference numbers for the articles by Kao and
Chey.
4) 2nd to last paragraph of Discussion: “the incidence was almost 20%.” Should
read “prevalence.”
5) Same paragraph: “College of Gastroenterology” should read “American
College of Gastroenterology”
6) Tables II and III mis-spell lymphocytic
7) Figures 1 and 2 are redundant to the tables, and could be omitted.
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:The Frequency Of Microscopic And Focal Active Colitis In Patients With
Irritable Bowel Syndrome
Version: 2Date:25 May 2011
Reviewer: Joel H Rubenstein
Reviewer's report:
The authors have conducted a cross-sectional case-control study estimating the
association of symptoms of IBS with microscopic colitis, finding that it is found in
3% of IBS patients, and 4.3% of non-constipated IBS patients. They also report a
substantial minority of IBS patients with focal active colitis.
Major concerns:
1) The average age of the IBS patients was 46, which seems higher than in most
studies, and might explain the relatively high proportion found to have MC. What
were the ages of the IBS patients found to have MC? Table I suggests that
patients greater than age 50 with IBS symptoms were excluded – is this not the
case?
2) Was the terminal ileum intubated routinely to exclude crohn’s ileitis?
3) 2nd to last paragraph of results: “biopsy samples were taken … to ascertain
that there was no pathology present in the controls.” - were controls excluded if
they have abnormal pathology? If so, this would be an error, as the comparison
of prevalence of MC or focal colitis would be biased by selection.
4) Were no patients found to have collagenous colitis?
Minor suggestions:
1) The classification of Groups I, II, and III are not well known and cumbersome
for the reader. The authors might change this to IBS-C, IBS-D, and IBS-M
(constipation, diarrhea, mixed).
2) Results first paragraph states that the average age of both groups was
identical, which contradicts Table 2 and later in the paragraph.
3) Discussion first paragraph omits reference numbers for the articles by Kao and
Chey.
4) 2nd to last paragraph of Discussion: “the incidence was almost 20%.” Should
read “prevalence.”
5) Same paragraph: “College of Gastroenterology” should read “American
College of Gastroenterology”
6) Tables II and III mis-spell lymphocytic
7) Figures 1 and 2 are redundant to the tables, and could be omitted.
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:The Frequency Of Microscopic And Focal Active Colitis In Patients With
Irritable Bowel Syndrome
Version: 2Date:25 May 2011
Reviewer: Joel H Rubenstein
Reviewer's report:
The authors have conducted a cross-sectional case-control study estimating the
association of symptoms of IBS with microscopic colitis, finding that it is found in
3% of IBS patients, and 4.3% of non-constipated IBS patients. They also report a
substantial minority of IBS patients with focal active colitis.
Major concerns:
1) The average age of the IBS patients was 46, which seems higher than in most
studies, and might explain the relatively high proportion found to have MC. What
were the ages of the IBS patients found to have MC? Table I suggests that
patients greater than age 50 with IBS symptoms were excluded – is this not the
case?
2) Was the terminal ileum intubated routinely to exclude crohn’s ileitis?
3) 2nd to last paragraph of results: “biopsy samples were taken … to ascertain
that there was no pathology present in the controls.” - were controls excluded if
they have abnormal pathology? If so, this would be an error, as the comparison
of prevalence of MC or focal colitis would be biased by selection.
4) Were no patients found to have collagenous colitis?
Minor suggestions:
1) The classification of Groups I, II, and III are not well known and cumbersome
for the reader. The authors might change this to IBS-C, IBS-D, and IBS-M
(constipation, diarrhea, mixed).
2) Results first paragraph states that the average age of both groups was
identical, which contradicts Table 2 and later in the paragraph.
3) Discussion first paragraph omits reference numbers for the articles by Kao and
Chey.
4) 2nd to last paragraph of Discussion: “the incidence was almost 20%.” Should
read “prevalence.”
5) Same paragraph: “College of Gastroenterology” should read “American
College of Gastroenterology”
6) Tables II and III mis-spell lymphocytic
7) Figures 1 and 2 are redundant to the tables, and could be omitted.
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.
assistant