Reviewer ’s report  
 
Title: The impact of overlapping functional dyspepsia, belching disorders and functional  
heartburn on anxiety, depression and quality of life of Chinese patients with irritable bowel  
syndrome  
 
Version: 2 Date: 07 Jun 2019  
 
Reviewer: Peyman - Adibi  
 
Reviewer's report:  
 
The paper presents a cross sectional clinic -based study that included IBS patients based on Rome 
III criteria and investigated coexistence of upper FGIDs as well as psychological and QOL 
determinants in them .  
1- The 2nd and third could be merged b ut there is a difference  in these two and also in the 
results text : The authors insisted on four FGIDs i.e. IBS,FD,FH,BD but in table 3 BD/FH seems 
to be a merged character so we could not see more than three FGIDs.  
2- When FD presents in three rows in t able 3 why those with FD (regardless of presence or 
absence of other upper FGIDs) was not considered as a 0 -1 variable i.e IBS+FD vs IBS( -FD); 
this may be done for FH too.  
3- The effect size seems quite marginal; to enable better interpretation of results you would be 
better to calculate OR as well.  
4- The whole idea of this study is the following items and these must be clearly replied in 
discussion  :  
a- if symptoms present in upper and lower parts, it would be correlated with poorer QOL or 
HADS  
b- if the ptient fits more than one upper FGID ,it would be correlated with poorer QOL or HADS  
 
 
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
No 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Yes 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manuscript or would you recommend an  
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects require further  
assessment in your comments to the editors.  
 
I am able to assess the statistics  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following question s: 
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from an  
organisation that may in any way gain or lose financially from the publication of this  
manuscript, either now or in the future?  
 
2. Do you hold any stocks or sha res in an organisation that may in any way gain or lose  
financially from the publication of this manuscript, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents relating to the content of the  
manuscript?  
 
4. Have you re ceived reimbursements, fees, funding, or salary from an organization that 
holds  or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interes ts in relation to this paper?  
 
If you can answer no to all of the above, write 'I declare that I have no competing interests' 
below.  If your reply is yes to any, please give details below.  
 
None  
 
I agree to the open peer review policy of the journal. I unders tand that my name will be included  
on my report to the authors and, if the manuscript is accepted for publication, my named report  
including any attachments I upload will be posted on the website along with the authors'  
responses. I agree for my report to be made available under an Open Access Creative Commons  
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments  
which I do not wish to be included in my named report can be included as confidential comments  
to the editor s, which will not be published.  
 
I agree to the open peer review policy of the journal  
Reviewer ’s report  
 
Title: The impact of overlapping functional dyspepsia, belching disorders and functional  
heartburn on anxiety, depression and quality of life of Chinese patients with irritable bowel  
syndrome  
 
Version: 2 Date: 07 Jun 2019  
 
Reviewer: Peyman - Adibi  
 
Reviewer's report:  
 
The paper presents a cross sectional clinic -based study that included IBS patients based on Rome 
III criteria and investigated coexistence of upper FGIDs as well as psychological and QOL 
determinants in them .  
1- The 2nd and third could be merged b ut there is a difference  in these two and also in the 
results text : The authors insisted on four FGIDs i.e. IBS,FD,FH,BD but in table 3 BD/FH seems 
to be a merged character so we could not see more than three FGIDs.  
2- When FD presents in three rows in t able 3 why those with FD (regardless of presence or 
absence of other upper FGIDs) was not considered as a 0 -1 variable i.e IBS+FD vs IBS( -FD); 
this may be done for FH too.  
3- The effect size seems quite marginal; to enable better interpretation of results you would be 
better to calculate OR as well.  
4- The whole idea of this study is the following items and these must be clearly replied in 
discussion  :  
a- if symptoms present in upper and lower parts, it would be correlated with poorer QOL or 
HADS  
b- if the ptient fits more than one upper FGID ,it would be correlated with poorer QOL or HADS  
 
 
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
No 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Yes 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manuscript or would you recommend an  
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects require further  
assessment in your comments to the editors.  
 
I am able to assess the statistics  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following question s: 
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from an  
organisation that may in any way gain or lose financially from the publication of this  
manuscript, either now or in the future?  
 
2. Do you hold any stocks or sha res in an organisation that may in any way gain or lose  
financially from the publication of this manuscript, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents relating to the content of the  
manuscript?  
 
4. Have you re ceived reimbursements, fees, funding, or salary from an organization that 
holds  or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interes ts in relation to this paper?  
 
If you can answer no to all of the above, write 'I declare that I have no competing interests' 
below.  If your reply is yes to any, please give details below.  
 
None  
 
I agree to the open peer review policy of the journal. I unders tand that my name will be included  
on my report to the authors and, if the manuscript is accepted for publication, my named report  
including any attachments I upload will be posted on the website along with the authors'  
responses. I agree for my report to be made available under an Open Access Creative Commons  
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments  
which I do not wish to be included in my named report can be included as confidential comments  
to the editor s, which will not be published.  
 
I agree to the open peer review policy of the journal  
Please review this paper.
user
Reviewer ’s report  
 
Title: The impact of overlapping functional dyspepsia, belching disorders and functional  
heartburn on anxiety, depression and quality of life of Chinese patients with irritable bowel  
syndrome  
 
Version: 2 Date: 07 Jun 2019  
 
Reviewer: Peyman - Adibi  
 
Reviewer's report:  
 
The paper presents a cross sectional clinic -based study that included IBS patients based on Rome 
III criteria and investigated coexistence of upper FGIDs as well as psychological and QOL 
determinants in them .  
1- The 2nd and third could be merged b ut there is a difference  in these two and also in the 
results text : The authors insisted on four FGIDs i.e. IBS,FD,FH,BD but in table 3 BD/FH seems 
to be a merged character so we could not see more than three FGIDs.  
2- When FD presents in three rows in t able 3 why those with FD (regardless of presence or 
absence of other upper FGIDs) was not considered as a 0 -1 variable i.e IBS+FD vs IBS( -FD); 
this may be done for FH too.  
3- The effect size seems quite marginal; to enable better interpretation of results you would be 
better to calculate OR as well.  
4- The whole idea of this study is the following items and these must be clearly replied in 
discussion  :  
a- if symptoms present in upper and lower parts, it would be correlated with poorer QOL or 
HADS  
b- if the ptient fits more than one upper FGID ,it would be correlated with poorer QOL or HADS  
 
 
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
No 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Yes 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manuscript or would you recommend an  
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects require further  
assessment in your comments to the editors.  
 
I am able to assess the statistics  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following question s: 
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from an  
organisation that may in any way gain or lose financially from the publication of this  
manuscript, either now or in the future?  
 
2. Do you hold any stocks or sha res in an organisation that may in any way gain or lose  
financially from the publication of this manuscript, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents relating to the content of the  
manuscript?  
 
4. Have you re ceived reimbursements, fees, funding, or salary from an organization that 
holds  or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interes ts in relation to this paper?  
 
If you can answer no to all of the above, write 'I declare that I have no competing interests' 
below.  If your reply is yes to any, please give details below.  
 
None  
 
I agree to the open peer review policy of the journal. I unders tand that my name will be included  
on my report to the authors and, if the manuscript is accepted for publication, my named report  
including any attachments I upload will be posted on the website along with the authors'  
responses. I agree for my report to be made available under an Open Access Creative Commons  
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments  
which I do not wish to be included in my named report can be included as confidential comments  
to the editor s, which will not be published.  
 
I agree to the open peer review policy of the journal  
assistant