Reviewer ’s report  
 
Title: Elobixibat alleviates chronic constipation in hemodial ysis patients: A questionnaire -based 
study  
 
Version: 1 Date: 04 Dec 2019  
 
Reviewer: Massimo Bellini  
 
Reviewer's report:  
 
This is an interesting study dealing with the effects of elobixibat in hemodialysis cnstipated 
patients.  
 
-English language needs to be improved.  
 
 
ABSTRACT  
 
 "..to evaluate the effect of elobixibact effect on…"   delete the second "effect"  
 
 
BACKGROUND  
 
When the authors deal wit QOL they could profitably cite the ChroCoDiTe study  BMC 2017 by 
Bellini M. et al in which the PacQol questionnaire was extensively us ed 
 
What is the exact meaning of "broad definition" referred to chronic constipaton?  
 
The prevalence  of CC in hemodialysis patients of 36.3% -66.7% according to GSRS (and not 
according to Rome Criteria) is really debatable and should deserve a brief discu ssion.  
 
 
RESULTS  
 
Did the authors evaluate possible side effects of elobixibat?  
 
Due to the patients'age  a colonoscopy was performed ?  
 
Tab.1 Which is the difference between Sennoside and sennoside granules?  
 
Pag. 10 line 2: "..number of constipation drugs" It would be better "laxatives"  
 
 
DISCUSSION  
 
What is the meaning of  "inevitable" referred to constipation? Every physiologic function is, 
someway, inevitable...  
 
When the authors discuss the possible therape utic options they could profitably cite the 
consensus produced by AIGO -SICCR in 2012 and published on World Journal of 
Gastroenterology by Bove A et al  
 
Pag14 line 20 -22: a brief description of elobixibat metabolization and its renal safety would be 
really  useful.  
 
Pag 15 line 12 :  "serum IP" This abbreviation is not mentioned in the list of abbrevations  
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are require d in your comments to the authors.  
 
No 
 
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 manus cript or would you recommend an 
additional  statistical review?  
If an additional statistical review is recommended, please speci fy 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 l anguage in the manuscript:  
 
Needs some language corrections before being published  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1.  Have you in the past five years received reim bursements, f ees, funding, or salary 
from an organisation that may in any way gain or lose financial ly from the 
publication of this manuscript, either now or in the future?  
 
2.  Do you hold any stocks or shares 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 received reimbursements, fees, funding, or salary fro m 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 interests 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.  
 
I declare that I have no competing interests  
 
I agree to the open peer review policy of the journal. I understand that m y name will be included 
on my report to the authors and, if the manuscript is accepted f or 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 ava ilable 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 in cluded as confidential comments 
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
Reviewer ’s report  
 
Title: Elobixibat alleviates chronic constipation in hemodial ysis patients: A questionnaire -based 
study  
 
Version: 1 Date: 04 Dec 2019  
 
Reviewer: Massimo Bellini  
 
Reviewer's report:  
 
This is an interesting study dealing with the effects of elobixibat in hemodialysis cnstipated 
patients.  
 
-English language needs to be improved.  
 
 
ABSTRACT  
 
 "..to evaluate the effect of elobixibact effect on…"   delete the second "effect"  
 
 
BACKGROUND  
 
When the authors deal wit QOL they could profitably cite the ChroCoDiTe study  BMC 2017 by 
Bellini M. et al in which the PacQol questionnaire was extensively us ed 
 
What is the exact meaning of "broad definition" referred to chronic constipaton?  
 
The prevalence  of CC in hemodialysis patients of 36.3% -66.7% according to GSRS (and not 
according to Rome Criteria) is really debatable and should deserve a brief discu ssion.  
 
 
RESULTS  
 
Did the authors evaluate possible side effects of elobixibat?  
 
Due to the patients'age  a colonoscopy was performed ?  
 
Tab.1 Which is the difference between Sennoside and sennoside granules?  
 
Pag. 10 line 2: "..number of constipation drugs" It would be better "laxatives"  
 
 
DISCUSSION  
 
What is the meaning of  "inevitable" referred to constipation? Every physiologic function is, 
someway, inevitable...  
 
When the authors discuss the possible therape utic options they could profitably cite the 
consensus produced by AIGO -SICCR in 2012 and published on World Journal of 
Gastroenterology by Bove A et al  
 
Pag14 line 20 -22: a brief description of elobixibat metabolization and its renal safety would be 
really  useful.  
 
Pag 15 line 12 :  "serum IP" This abbreviation is not mentioned in the list of abbrevations  
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are require d in your comments to the authors.  
 
No 
 
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 manus cript or would you recommend an 
additional  statistical review?  
If an additional statistical review is recommended, please speci fy 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 l anguage in the manuscript:  
 
Needs some language corrections before being published  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1.  Have you in the past five years received reim bursements, f ees, funding, or salary 
from an organisation that may in any way gain or lose financial ly from the 
publication of this manuscript, either now or in the future?  
 
2.  Do you hold any stocks or shares 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 received reimbursements, fees, funding, or salary fro m 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 interests 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.  
 
I declare that I have no competing interests  
 
I agree to the open peer review policy of the journal. I understand that m y name will be included 
on my report to the authors and, if the manuscript is accepted f or 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 ava ilable 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 in cluded as confidential comments 
to the editors, 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: Elobixibat alleviates chronic constipation in hemodial ysis patients: A questionnaire -based 
study  
 
Version: 1 Date: 04 Dec 2019  
 
Reviewer: Massimo Bellini  
 
Reviewer's report:  
 
This is an interesting study dealing with the effects of elobixibat in hemodialysis cnstipated 
patients.  
 
-English language needs to be improved.  
 
 
ABSTRACT  
 
 "..to evaluate the effect of elobixibact effect on…"   delete the second "effect"  
 
 
BACKGROUND  
 
When the authors deal wit QOL they could profitably cite the ChroCoDiTe study  BMC 2017 by 
Bellini M. et al in which the PacQol questionnaire was extensively us ed 
 
What is the exact meaning of "broad definition" referred to chronic constipaton?  
 
The prevalence  of CC in hemodialysis patients of 36.3% -66.7% according to GSRS (and not 
according to Rome Criteria) is really debatable and should deserve a brief discu ssion.  
 
 
RESULTS  
 
Did the authors evaluate possible side effects of elobixibat?  
 
Due to the patients'age  a colonoscopy was performed ?  
 
Tab.1 Which is the difference between Sennoside and sennoside granules?  
 
Pag. 10 line 2: "..number of constipation drugs" It would be better "laxatives"  
 
 
DISCUSSION  
 
What is the meaning of  "inevitable" referred to constipation? Every physiologic function is, 
someway, inevitable...  
 
When the authors discuss the possible therape utic options they could profitably cite the 
consensus produced by AIGO -SICCR in 2012 and published on World Journal of 
Gastroenterology by Bove A et al  
 
Pag14 line 20 -22: a brief description of elobixibat metabolization and its renal safety would be 
really  useful.  
 
Pag 15 line 12 :  "serum IP" This abbreviation is not mentioned in the list of abbrevations  
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are require d in your comments to the authors.  
 
No 
 
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 manus cript or would you recommend an 
additional  statistical review?  
If an additional statistical review is recommended, please speci fy 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 l anguage in the manuscript:  
 
Needs some language corrections before being published  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1.  Have you in the past five years received reim bursements, f ees, funding, or salary 
from an organisation that may in any way gain or lose financial ly from the 
publication of this manuscript, either now or in the future?  
 
2.  Do you hold any stocks or shares 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 received reimbursements, fees, funding, or salary fro m 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 interests 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.  
 
I declare that I have no competing interests  
 
I agree to the open peer review policy of the journal. I understand that m y name will be included 
on my report to the authors and, if the manuscript is accepted f or 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 ava ilable 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 in cluded as confidential comments 
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
assistant