Author’s Response

We thank the reader for pointing out this important issue in our previous meta-analysis. [1] We wish to clarify that we have included both Michna et al [2] and Iyer et al [3] albeit being the same study because one of the secondary outcomes in the meta-analysis is "change in pain scores" and the data for this outcome was provided only by the latter article. We have not included the data from latter study for assessment of any other outcomes. Similarly, Thomas et al [4] and Chamberlain et al [5] although are the same studies, the data on another secondary outcome, "Time to achieve rescue free bowel movement" was not stated clearly in the former article for placebo group unlike the latter and so it was included for this outcome analysis and the reported pooled estimate for this outcome was not significantly different from placebo for subcutaneous methyl naltrexone.

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