Review for 10.1186/s12876-022-02118-y (2022)

Reviewer’s report
Title: 
Overlap between irritable bowel syndrome and common gastrointestinal
diagnoses: a retrospective cohort study of 29,553 outpatients in Germany
Version: 
1 
Date: 
27 Dec 2021
Reviewer's report:
This Research article shows the importance of continuous re-examination of the
already established diagnosis of diseases of the gastrointestinal system because
evidently, that there is a possibility of multiple diseases at the same time. It often
happens that in the case of a diagnosis of IBS, all the symptoms that occur later
are attributed to IBS, given its multivariate form of the disease.
Early intestinal infectious disease was expected to be common as it is known that
microflora disorder is one of the underlying causes of IBS. 
It would certainly be desirable in the paper to explain how another disease is
excluded in order to meet all the criteria in the diagnosis of IBS, as you yourself
mentioned that it is a diagnosis by excluding other diseases. The question is
whether the earlier diagnosis of IBS is really accurate and correct.
Also, in further research it would be good to divide patients by groups of
symptoms that predominate in IBS and try to link them to certain overlapping
diseases of the gastrointestinal system. Be sure to consider patients' life habits
because we know that stress has a big impact on onset and course of IBS.
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