Reviewer's report
Title:Rumination syndrome in children and adolescents: a school survey
assessing prevalence and symptomatology
Version: 2Date:6 June 2012
Reviewer: Guillaume Gourcerol
Reviewer's report:
The question raised in the paper from Rajindrajith and colleagues, eg the
prevalence of rumination among children, remains to date unsolved as
underlined by the authors. To this perspective, the study brings some novelty.
However, the data presented in this paper, eg the prevalence is up to 5%, are to
some extent unexpected. In fact, rumination syndrome is believed (wrong or
right) to be extremely uncommon, at least in western countries where it has been
studied more extensively. To me, there is one major pitfall in this study that
needs to be clarified. I am not sure whether the authors have picked up from their
survey the symptoms of rumination or symptoms of GERD. In fact, the authors
used an auto-questionnaire, while the rome III criteria have not been designed to
be used as self-administered questionnaires. Indeed, it might be difficult for an
adult (and even more for a child) to make the difference between GERD
symptoms (for instance regurgitation of food) and rumination symptoms
(regurgitation of food that has to be reshewed). Confusion can be also increased
by using translated questionnaires that have not been validated vs the original
English one. The confusion appears even more obvious to me when addressing
the nocturnal occurrence of symptoms, that is present in the exclusion criteria
“-b. do not occur during sleep”, while “13.6% had difficulty in sleeping due to
symptoms of rumination”. Therefore, to clarify this issue, and to ascertain that the
unexpected prevalence of rumination syndrome in Sri Lanka holds true, the
authors should provide also the prevalence of GERD symptoms, including
heartburn and regurgitation.
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: Yes, and I have assessed the statistics in my report.
Declaration of competing interests:
I declare that I have no competing interests
Reviewer's report
Title:Rumination syndrome in children and adolescents: a school survey
assessing prevalence and symptomatology
Version: 2Date:6 June 2012
Reviewer: Guillaume Gourcerol
Reviewer's report:
The question raised in the paper from Rajindrajith and colleagues, eg the
prevalence of rumination among children, remains to date unsolved as
underlined by the authors. To this perspective, the study brings some novelty.
However, the data presented in this paper, eg the prevalence is up to 5%, are to
some extent unexpected. In fact, rumination syndrome is believed (wrong or
right) to be extremely uncommon, at least in western countries where it has been
studied more extensively. To me, there is one major pitfall in this study that
needs to be clarified. I am not sure whether the authors have picked up from their
survey the symptoms of rumination or symptoms of GERD. In fact, the authors
used an auto-questionnaire, while the rome III criteria have not been designed to
be used as self-administered questionnaires. Indeed, it might be difficult for an
adult (and even more for a child) to make the difference between GERD
symptoms (for instance regurgitation of food) and rumination symptoms
(regurgitation of food that has to be reshewed). Confusion can be also increased
by using translated questionnaires that have not been validated vs the original
English one. The confusion appears even more obvious to me when addressing
the nocturnal occurrence of symptoms, that is present in the exclusion criteria
“-b. do not occur during sleep”, while “13.6% had difficulty in sleeping due to
symptoms of rumination”. Therefore, to clarify this issue, and to ascertain that the
unexpected prevalence of rumination syndrome in Sri Lanka holds true, the
authors should provide also the prevalence of GERD symptoms, including
heartburn and regurgitation.
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: Yes, and I have assessed the statistics in my report.
Declaration of competing interests:
I declare that I have no competing interests
Please review this paper.
user
Reviewer's report
Title:Rumination syndrome in children and adolescents: a school survey
assessing prevalence and symptomatology
Version: 2Date:6 June 2012
Reviewer: Guillaume Gourcerol
Reviewer's report:
The question raised in the paper from Rajindrajith and colleagues, eg the
prevalence of rumination among children, remains to date unsolved as
underlined by the authors. To this perspective, the study brings some novelty.
However, the data presented in this paper, eg the prevalence is up to 5%, are to
some extent unexpected. In fact, rumination syndrome is believed (wrong or
right) to be extremely uncommon, at least in western countries where it has been
studied more extensively. To me, there is one major pitfall in this study that
needs to be clarified. I am not sure whether the authors have picked up from their
survey the symptoms of rumination or symptoms of GERD. In fact, the authors
used an auto-questionnaire, while the rome III criteria have not been designed to
be used as self-administered questionnaires. Indeed, it might be difficult for an
adult (and even more for a child) to make the difference between GERD
symptoms (for instance regurgitation of food) and rumination symptoms
(regurgitation of food that has to be reshewed). Confusion can be also increased
by using translated questionnaires that have not been validated vs the original
English one. The confusion appears even more obvious to me when addressing
the nocturnal occurrence of symptoms, that is present in the exclusion criteria
“-b. do not occur during sleep”, while “13.6% had difficulty in sleeping due to
symptoms of rumination”. Therefore, to clarify this issue, and to ascertain that the
unexpected prevalence of rumination syndrome in Sri Lanka holds true, the
authors should provide also the prevalence of GERD symptoms, including
heartburn and regurgitation.
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: Yes, and I have assessed the statistics in my report.
Declaration of competing interests:
I declare that I have no competing interests
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