Review for 10.1186/s12876-021-01637-4 (2021)

Reviewer’s report
Title: 
Prevalence of biliary acid malabsorption in patients with chronic diarrhoea
of functional characteristics. A prospective study.
Version: 
0 
Date: 
27 Aug 2020
Reviewer's report:
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Response to the authors:
This is an important paper as there have only been 6 prospective cohort studies
identified to date using SeHCAT scanning to diagnose bile acid malabsoprtion
(NICE Review, 2020). 
Suggestions for improvement:
It would be good to define this is a prospective cohort in the title as
recommended by the STROBE guidelines for reporting observational cohort
studies (von Elm et al., 2018).
p4 line 26. The full stop is in superscript after ref 11. 
Under requires a capital U
as a new sentence.
p5: 
there needs to be a stronger rationale for using a cut off value of < 10% 7
day SeHCAT retention as this is not what other guidance/ papers recommend.
Why was this so strict?
There should be more to this paper than the aim to say a SeHCAT scan needs to
be considered in people with functional GI disorders. All other papers already do
this. 
Where this paper may contribute further is by suggesting alternative ways of
treating bile acid malabsorption which I feel is completely missing from the
paper.
p6 line 8: with the absence of warning signals… this is confusing. Do the
authors mean there is no weight loss, nocturnal defaecation or steatorrhoea in
people with a possible diagnosis of BAM? My understanding of warning
symptoms is that this would be: unintentional weight loss, rectal bleeding, upper
GI bleeding. Please clarify. 
P6 line 11. 
Please clarify what 'direct parasite examination' involves. 
P 7, line 2.
The word 'at' is missing 
before a retention of < 10%
Discussion: 
p9, line 10. 
Please explain further the rationale for using stricter criteria to
diagnose BAM and consider how this could have influenced your findings.
p9, line 19 and 23. Please add the p-value (p= 0.25 obesity) (p= 0.006 BMI).
Please define obesity.
p11, line 2. Please discuss other options to treat BAM ie. low fat diet,
colesevelam, low doses of loperamide. Please also consider this in relation to
your non-responders. 
Specifically those who stopped treatment due to
constipation. 
Table 1. please provide a definition for obesity.
Table 2- 3. 
please add definitions ie age, years, symptom duration (years - stated
in text p 10 line 21), faecal urgency (? Number of episodes per day?), dose of
cholestiramine (? g/ sachet).
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