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: 3Date:3 January 2013
Reviewer: Greger Lindberg
Reviewer's report:
The authors have substantially improved their manuscript and my impression is
that they have adequately responded to my previous comments. A few more but
minor comments can be made:
Minor essential revisions:
1. The reference list has not been formatted according to BMC style. Year of
publication is missing in all references. There should be a space between the :
after the last author and the title of the article, and there should be a space
between . after the article title and the journal abbreviation. The latter should be
followed by the year of publication.
2. The title refers to "diarrhoea predominant irritable bowel syndrome" which is a
term that was used in the Rome-II classification of functional bowel disorders, but
in the article the authors use the term "irritable bowel syndrome with diarrhoea"
which is the correct term in Rome-III classification. I think the title should be
changed to reflect the fact that patients were classified according to Rome-III.
Discretionary Revision (perhaps for discussion):
3. This is perhaps more a comment than a question that can be answered: When
doing a scientific study on a population with the label "IBS-D" it is important to
understand under what circumstances this label was attached to patients. If it
sufficed to fulfil the symptom criteria for IBS and IBS-D and no investigations had
been done the population would include patients with celiac disease, bile salt
malabsorption, exocrine pancreatic insufficiency, collagenous colitis and perhaps
a number of other causes for similar symptoms. Although it has been argued that
it is in general safe to make the diagnosis of IBS positively by using symptom
criteria alone, the reality is, and this has been shown in a number of studies that
many diseases can mimic IBS. For practical purposes, perhaps the only
important question is if the proportion of cases with an organic cause is small
enough to be neglected. In the present study all patients were colonoscopy
naïve. How many organic causes of IBS-like symptoms had been excluded? Was
the number of patients with collagenous colits (1/74) small enough to be
neglected as an organic and treatable cause of IBS-like symptoms?
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: 3Date:3 January 2013
Reviewer: Greger Lindberg
Reviewer's report:
The authors have substantially improved their manuscript and my impression is
that they have adequately responded to my previous comments. A few more but
minor comments can be made:
Minor essential revisions:
1. The reference list has not been formatted according to BMC style. Year of
publication is missing in all references. There should be a space between the :
after the last author and the title of the article, and there should be a space
between . after the article title and the journal abbreviation. The latter should be
followed by the year of publication.
2. The title refers to "diarrhoea predominant irritable bowel syndrome" which is a
term that was used in the Rome-II classification of functional bowel disorders, but
in the article the authors use the term "irritable bowel syndrome with diarrhoea"
which is the correct term in Rome-III classification. I think the title should be
changed to reflect the fact that patients were classified according to Rome-III.
Discretionary Revision (perhaps for discussion):
3. This is perhaps more a comment than a question that can be answered: When
doing a scientific study on a population with the label "IBS-D" it is important to
understand under what circumstances this label was attached to patients. If it
sufficed to fulfil the symptom criteria for IBS and IBS-D and no investigations had
been done the population would include patients with celiac disease, bile salt
malabsorption, exocrine pancreatic insufficiency, collagenous colitis and perhaps
a number of other causes for similar symptoms. Although it has been argued that
it is in general safe to make the diagnosis of IBS positively by using symptom
criteria alone, the reality is, and this has been shown in a number of studies that
many diseases can mimic IBS. For practical purposes, perhaps the only
important question is if the proportion of cases with an organic cause is small
enough to be neglected. In the present study all patients were colonoscopy
naïve. How many organic causes of IBS-like symptoms had been excluded? Was
the number of patients with collagenous colits (1/74) small enough to be
neglected as an organic and treatable cause of IBS-like symptoms?
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: 3Date:3 January 2013
Reviewer: Greger Lindberg
Reviewer's report:
The authors have substantially improved their manuscript and my impression is
that they have adequately responded to my previous comments. A few more but
minor comments can be made:
Minor essential revisions:
1. The reference list has not been formatted according to BMC style. Year of
publication is missing in all references. There should be a space between the :
after the last author and the title of the article, and there should be a space
between . after the article title and the journal abbreviation. The latter should be
followed by the year of publication.
2. The title refers to "diarrhoea predominant irritable bowel syndrome" which is a
term that was used in the Rome-II classification of functional bowel disorders, but
in the article the authors use the term "irritable bowel syndrome with diarrhoea"
which is the correct term in Rome-III classification. I think the title should be
changed to reflect the fact that patients were classified according to Rome-III.
Discretionary Revision (perhaps for discussion):
3. This is perhaps more a comment than a question that can be answered: When
doing a scientific study on a population with the label "IBS-D" it is important to
understand under what circumstances this label was attached to patients. If it
sufficed to fulfil the symptom criteria for IBS and IBS-D and no investigations had
been done the population would include patients with celiac disease, bile salt
malabsorption, exocrine pancreatic insufficiency, collagenous colitis and perhaps
a number of other causes for similar symptoms. Although it has been argued that
it is in general safe to make the diagnosis of IBS positively by using symptom
criteria alone, the reality is, and this has been shown in a number of studies that
many diseases can mimic IBS. For practical purposes, perhaps the only
important question is if the proportion of cases with an organic cause is small
enough to be neglected. In the present study all patients were colonoscopy
naïve. How many organic causes of IBS-like symptoms had been excluded? Was
the number of patients with collagenous colits (1/74) small enough to be
neglected as an organic and treatable cause of IBS-like symptoms?
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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