Reviewer's report
Title:Dyspeptic Symptoms and Delayed Gastric Emptying of Solids in Patients
with Inactive Crohn's Disease.
Version: 1Date:2 April 2012
Reviewer: J Keller
Reviewer's report:
Reviewer's report
-----------------
The authors investigated 26 patients with inactive Crohn’s disease as indicated
by CDAI < 150. They performed 13C-octanoic breath tests for measurement of
gastric emptying of solids and used a questionnaire for evaluation of dyspeptic
symptoms. Their data confirm that a subset of patients with CD, who have no
clinical evidence of inflammatory activity, show delayed gastric emptying. They
also show an association between delayed gastric emptying and dyspeptic
symptoms which has not been assessed before in CD patients. Thus, their
findings may be of pathophysiological relevance. However, some methodological
aspects need clarification and interpretation of some of the results remains
unclear.
Major compulsory revisions:
1. The symptom questionnaire used is not well known and, thus, the authors
should describe it in more detail (e.g. how does a questionnaire asking for 5
items result in a maximum of 44? what does a score of 6 mean?)
2. The authors claim to have used the methodolgy established by Ghoos et al.
and to have taken normal data derived from this study into account. However, the
upper limit of normal was well below 200 min in the study published by Ghoos et
al. Moreover, 15-20% of the control subjects have pathologically delayed gastric
emptying or at least borderline results according to the normal values given (fig.
1). These aspects need further explanation.
3. Intra- and interindividual variability of gastric emptying is rather high. In
contrast, the authors report extremely small standard deviations (?) for t lag and t
1/2. Please explain.
4. Data for t ½ in CD patients with and without dyspepsia are largely overlapping
(fig 2). Please state statistic test used and the exact p-value when comparing
these data.
5. The mean PADYQ score for vomiting in CD patients is extremely low (fig. 3: <1
in pts with normal gastric emptying, <2 in patients with delayed GE) and standard
deviation (?) is small. How is it possible that the authors observed a significant
correlation between gastric emptying velocity and PADYQ score fort his specific
subscale?
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:Dyspeptic Symptoms and Delayed Gastric Emptying of Solids in Patients
with Inactive Crohn's Disease.
Version: 1Date:2 April 2012
Reviewer: J Keller
Reviewer's report:
Reviewer's report
-----------------
The authors investigated 26 patients with inactive Crohn’s disease as indicated
by CDAI < 150. They performed 13C-octanoic breath tests for measurement of
gastric emptying of solids and used a questionnaire for evaluation of dyspeptic
symptoms. Their data confirm that a subset of patients with CD, who have no
clinical evidence of inflammatory activity, show delayed gastric emptying. They
also show an association between delayed gastric emptying and dyspeptic
symptoms which has not been assessed before in CD patients. Thus, their
findings may be of pathophysiological relevance. However, some methodological
aspects need clarification and interpretation of some of the results remains
unclear.
Major compulsory revisions:
1. The symptom questionnaire used is not well known and, thus, the authors
should describe it in more detail (e.g. how does a questionnaire asking for 5
items result in a maximum of 44? what does a score of 6 mean?)
2. The authors claim to have used the methodolgy established by Ghoos et al.
and to have taken normal data derived from this study into account. However, the
upper limit of normal was well below 200 min in the study published by Ghoos et
al. Moreover, 15-20% of the control subjects have pathologically delayed gastric
emptying or at least borderline results according to the normal values given (fig.
1). These aspects need further explanation.
3. Intra- and interindividual variability of gastric emptying is rather high. In
contrast, the authors report extremely small standard deviations (?) for t lag and t
1/2. Please explain.
4. Data for t ½ in CD patients with and without dyspepsia are largely overlapping
(fig 2). Please state statistic test used and the exact p-value when comparing
these data.
5. The mean PADYQ score for vomiting in CD patients is extremely low (fig. 3: <1
in pts with normal gastric emptying, <2 in patients with delayed GE) and standard
deviation (?) is small. How is it possible that the authors observed a significant
correlation between gastric emptying velocity and PADYQ score fort his specific
subscale?
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:Dyspeptic Symptoms and Delayed Gastric Emptying of Solids in Patients
with Inactive Crohn's Disease.
Version: 1Date:2 April 2012
Reviewer: J Keller
Reviewer's report:
Reviewer's report
-----------------
The authors investigated 26 patients with inactive Crohn’s disease as indicated
by CDAI < 150. They performed 13C-octanoic breath tests for measurement of
gastric emptying of solids and used a questionnaire for evaluation of dyspeptic
symptoms. Their data confirm that a subset of patients with CD, who have no
clinical evidence of inflammatory activity, show delayed gastric emptying. They
also show an association between delayed gastric emptying and dyspeptic
symptoms which has not been assessed before in CD patients. Thus, their
findings may be of pathophysiological relevance. However, some methodological
aspects need clarification and interpretation of some of the results remains
unclear.
Major compulsory revisions:
1. The symptom questionnaire used is not well known and, thus, the authors
should describe it in more detail (e.g. how does a questionnaire asking for 5
items result in a maximum of 44? what does a score of 6 mean?)
2. The authors claim to have used the methodolgy established by Ghoos et al.
and to have taken normal data derived from this study into account. However, the
upper limit of normal was well below 200 min in the study published by Ghoos et
al. Moreover, 15-20% of the control subjects have pathologically delayed gastric
emptying or at least borderline results according to the normal values given (fig.
1). These aspects need further explanation.
3. Intra- and interindividual variability of gastric emptying is rather high. In
contrast, the authors report extremely small standard deviations (?) for t lag and t
1/2. Please explain.
4. Data for t ½ in CD patients with and without dyspepsia are largely overlapping
(fig 2). Please state statistic test used and the exact p-value when comparing
these data.
5. The mean PADYQ score for vomiting in CD patients is extremely low (fig. 3: <1
in pts with normal gastric emptying, <2 in patients with delayed GE) and standard
deviation (?) is small. How is it possible that the authors observed a significant
correlation between gastric emptying velocity and PADYQ score fort his specific
subscale?
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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