{"id":2114,"date":"2019-10-01T20:22:09","date_gmt":"2019-10-01T20:22:09","guid":{"rendered":"https:\/\/medicalcriteria.com\/web\/?p=2212"},"modified":"2026-02-03T19:11:51","modified_gmt":"2026-02-03T19:11:51","slug":"ulcerative-colitis-activity","status":"publish","type":"post","link":"https:\/\/medicalcriteria.com\/web\/es\/ulcerative-colitis-activity\/","title":{"rendered":"\u00cdndice de Actividad de Colitis Ulcerosa"},"content":{"rendered":"<div class=\"7ca9444b8380138fe077da07353677a4\" data-index=\"1\" style=\"float: none; margin:0px 0 0px 0; text-align:center;\">\n<script async src=\"https:\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js\"><\/script>\r\n<!-- MC 2019- Horizontal -->\r\n<ins class=\"adsbygoogle\"\r\n     style=\"display:block\"\r\n     data-ad-client=\"ca-pub-0127150553352455\"\r\n     data-ad-slot=\"3806776041\"\r\n     data-ad-format=\"auto\"\r\n     data-full-width-responsive=\"true\"><\/ins>\r\n<script>\r\n     (adsbygoogle = window.adsbygoogle || []).push({});\r\n<\/script>\n<\/div>\n<p>La colitis ulcerosa (CU) es una afecci\u00f3n inflamatoria cr\u00f3nica mediada por el sistema inmunitario del intestino grueso que con frecuencia se asocia con inflamaci\u00f3n del recto, pero a menudo se extiende de manera proximal para involucrar \u00e1reas adicionales del colon. Una vez que se hace un diagn\u00f3stico de CU, es importante determinar la gravedad de la enfermedad.<!--more--><\/p>\n<p><strong>\u00cdndice de actividad de colitis ulcerosa propuesto por el American College of Gastroenterology<\/strong><\/p>\n<table style=\"border-collapse: collapse; width: 100%;\" border=\"1\">\n<tbody>\n<tr>\n<td style=\"width: 26.7399%;\"><\/td>\n<td style=\"text-align: center; width: 16.2393%;\"><strong>Remisi\u00f3n<\/strong><\/td>\n<td style=\"text-align: center; width: 13.3089%;\"><strong>Leve<\/strong><\/td>\n<td style=\"text-align: center; width: 20.8791%;\"><strong>Moderado-severo<\/strong><\/td>\n<td style=\"text-align: center; width: 22.7106%;\"><strong>Fulminante<\/strong><\/td>\n<\/tr>\n<tr>\n<td style=\"width: 26.7399%;\">Heces (no.\/d)<\/td>\n<td style=\"text-align: center; width: 16.2393%;\">Formadas<\/td>\n<td style=\"text-align: center; width: 13.3089%;\">&lt;4<\/td>\n<td style=\"text-align: center; width: 20.8791%;\">&gt;6<\/td>\n<td style=\"text-align: center; width: 22.7106%;\">&gt;10<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 26.7399%;\">Sangre en heces<\/td>\n<td style=\"text-align: center; width: 16.2393%;\">No<\/td>\n<td style=\"text-align: center; width: 13.3089%;\">Intermitente<\/td>\n<td style=\"text-align: center; width: 20.8791%;\">Frecuente<\/td>\n<td style=\"text-align: center; width: 22.7106%;\">Continuo<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 26.7399%;\">Urgencia<\/td>\n<td style=\"text-align: center; width: 16.2393%;\">No<\/td>\n<td style=\"text-align: center; width: 13.3089%;\">Leve, ocasional<\/td>\n<td style=\"text-align: center; width: 20.8791%;\">A menudo<\/td>\n<td style=\"text-align: center; width: 22.7106%;\">Continuo<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 26.7399%;\">Hemoglobina<\/td>\n<td style=\"text-align: center; width: 16.2393%;\">Normal<\/td>\n<td style=\"text-align: center; width: 13.3089%;\">Normal<\/td>\n<td style=\"text-align: center; width: 20.8791%;\">75% del normal<\/td>\n<td style=\"text-align: center; width: 22.7106%;\">Transfusi\u00f3n requerida<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 26.7399%;\">VSG<\/td>\n<td style=\"text-align: center; width: 16.2393%;\">&lt;30<\/td>\n<td style=\"text-align: center; width: 13.3089%;\">&lt;30<\/td>\n<td style=\"text-align: center; width: 20.8791%;\">&gt;30<\/td>\n<td style=\"text-align: center; width: 22.7106%;\">&gt;30<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 26.7399%;\">PCR (mg\/L)<\/td>\n<td style=\"text-align: center; width: 16.2393%;\">Normal<\/td>\n<td style=\"text-align: center; width: 13.3089%;\">Elevada<\/td>\n<td style=\"text-align: center; width: 20.8791%;\">Elevada<\/td>\n<td style=\"text-align: center; width: 22.7106%;\">Elevada<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 26.7399%;\">CF (\u00b5g\/g)<\/td>\n<td style=\"text-align: center; width: 16.2393%;\">&lt;150\u2013200<\/td>\n<td style=\"text-align: center; width: 13.3089%;\">&gt;150\u2013200<\/td>\n<td style=\"text-align: center; width: 20.8791%;\">&gt;150\u2013200<\/td>\n<td style=\"text-align: center; width: 22.7106%;\">&gt;150\u2013200<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 26.7399%;\">Endoscop\u00eda (subscore Mayo)<\/td>\n<td style=\"text-align: center; width: 16.2393%;\">0-1<\/td>\n<td style=\"text-align: center; width: 13.3089%;\">1<\/td>\n<td style=\"text-align: center; width: 20.8791%;\">2-3<\/td>\n<td style=\"text-align: center; width: 22.7106%;\">3<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 26.7399%;\">UCEIS<\/td>\n<td style=\"text-align: center; width: 16.2393%;\">0-1<\/td>\n<td style=\"text-align: center; width: 13.3089%;\">2-4<\/td>\n<td style=\"text-align: center; width: 20.8791%;\">5-8<\/td>\n<td style=\"text-align: center; width: 22.7106%;\">7-8<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>Los factores anteriores son gu\u00edas generales para la actividad de la enfermedad. Con la excepci\u00f3n de la remisi\u00f3n, un paciente no necesita tener todos los factores para ser considerado en una categor\u00eda espec\u00edfica.<\/p>\n<p>PCR, prote\u00edna C reactiva; VSG, velocidad de sedimentaci\u00f3n globular; CF, calprotectina fecal; UCEIS, \u00edndice endosc\u00f3pico de gravedad de la colitis ulcerosa<\/p>\n<p><strong>Puntuaci\u00f3n de Mayo para la actividad de colitis ulcerosa<\/strong><\/p>\n<table style=\"border-collapse: collapse; width: 100%;\" border=\"1\">\n<tbody>\n<tr>\n<td>Par\u00e1metro<\/td>\n<td>Subscore (0\u20133)<\/td>\n<\/tr>\n<tr>\n<td>Frecuencia defecatoria<\/td>\n<td>0 = normal<br \/>\n1 = 1\u20132 dep\/d\u00eda m\u00e1s de lo habitual<br \/>\n2 = 3\u20134 dep\/d\u00eda m\u00e1s de lo habitual<br \/>\n3 = 5 dep\/d\u00eda o m\u00e1s de lo habitual<\/td>\n<\/tr>\n<tr>\n<td>Sangrado rectal<\/td>\n<td>0 = ninguno<br \/>\n1 = Hilos hem\u00e1ticos en menos de la mitad de las deposiciones<br \/>\n2 = Sangrado visible en la mayor\u00eda de las deposiciones<br \/>\n3 = Rectorragias sin heces<\/td>\n<\/tr>\n<tr>\n<td>Apariencia endosc\u00f3pica de la mucosa<\/td>\n<td>0 = normal o enfermedad inactiva<br \/>\n1 = leve (eritema, patr\u00f3n vascular disminuido, y friabilidad leve)<br \/>\n2 = moderado (eritema marcado, falta de patr\u00f3n vascular, friabilidad y erosiones)<br \/>\n3 = severo (sangrado espont\u00e1neo y ulceraciones)<\/td>\n<\/tr>\n<tr>\n<td>Valoraci\u00f3n m\u00e9dica global<\/td>\n<td>0 = normal<br \/>\n1 = enfermedad leve<br \/>\n2 = enfermedad moderada<br \/>\n3 = enfermedad severa<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p><strong>\u00cdndice de actividad de colitis cl\u00ednica simple<\/strong><\/p>\n<table style=\"border-collapse: collapse; width: 100%;\" border=\"1\">\n<tbody>\n<tr style=\"height: 24px;\">\n<td style=\"width: 404px; height: 24px;\" colspan=\"2\">S\u00edntomas<\/td>\n<td style=\"width: 160px; text-align: center; height: 24px;\">Score<\/td>\n<\/tr>\n<tr style=\"height: 24px;\">\n<td style=\"width: 268px; height: 96px;\" rowspan=\"4\">Frecuencia intestinal (d)<\/td>\n<td style=\"width: 126px; height: 24px; text-align: center;\">1-3<\/td>\n<td style=\"width: 160px; text-align: center; height: 24px;\">0<\/td>\n<\/tr>\n<tr style=\"height: 24px;\">\n<td style=\"width: 126px; height: 24px; text-align: center;\">4-6<\/td>\n<td style=\"width: 160px; text-align: center; height: 24px;\">1<\/td>\n<\/tr>\n<tr style=\"height: 24px;\">\n<td style=\"width: 126px; height: 24px; text-align: center;\">7-9<\/td>\n<td style=\"width: 160px; text-align: center; height: 24px;\">2<\/td>\n<\/tr>\n<tr style=\"height: 24px;\">\n<td style=\"width: 126px; height: 24px; text-align: center;\">9+<\/td>\n<td style=\"width: 160px; text-align: center; height: 24px;\">3<\/td>\n<\/tr>\n<tr style=\"height: 24px;\">\n<td style=\"width: 268px; height: 72px;\" rowspan=\"3\">Frecuencia intestinal (nocturna)<\/td>\n<td style=\"width: 126px; height: 24px; text-align: center;\">0<\/td>\n<td style=\"width: 160px; text-align: center; height: 24px;\">0<\/td>\n<\/tr>\n<tr style=\"height: 24px;\">\n<td style=\"width: 126px; height: 24px; text-align: center;\">1-3<\/td>\n<td style=\"width: 160px; text-align: center; height: 24px;\">1<\/td>\n<\/tr>\n<tr style=\"height: 24px;\">\n<td style=\"width: 126px; height: 24px; text-align: center;\">4-6<\/td>\n<td style=\"width: 160px; text-align: center; height: 24px;\">2<\/td>\n<\/tr>\n<tr style=\"height: 24px;\">\n<td style=\"width: 268px; height: 96px;\" rowspan=\"4\">Urgencia de defecaci\u00f3n<\/td>\n<td style=\"width: 126px; height: 24px; text-align: center;\">No<\/td>\n<td style=\"width: 160px; text-align: center; height: 24px;\">0<\/td>\n<\/tr>\n<tr style=\"height: 24px;\">\n<td style=\"width: 126px; height: 24px; text-align: center;\">Apuro<\/td>\n<td style=\"width: 160px; text-align: center; height: 24px;\">1<\/td>\n<\/tr>\n<tr style=\"height: 24px;\">\n<td style=\"width: 126px; height: 24px; text-align: center;\">Inmediato<\/td>\n<td style=\"width: 160px; text-align: center; height: 24px;\">2<\/td>\n<\/tr>\n<tr style=\"height: 24px;\">\n<td style=\"width: 126px; height: 24px; text-align: center;\">Incontinencia<\/td>\n<td style=\"width: 160px; text-align: center; height: 24px;\">3<\/td>\n<\/tr>\n<tr style=\"height: 24px;\">\n<td style=\"width: 268px; height: 96px;\" rowspan=\"4\">Sangre en heces<\/td>\n<td style=\"width: 126px; height: 24px; text-align: center;\">No<\/td>\n<td style=\"width: 160px; text-align: center; height: 24px;\">0<\/td>\n<\/tr>\n<tr style=\"height: 24px;\">\n<td style=\"width: 126px; height: 24px; text-align: center;\">Vestigios<\/td>\n<td style=\"width: 160px; text-align: center; height: 24px;\">1<\/td>\n<\/tr>\n<tr style=\"height: 24px;\">\n<td style=\"width: 126px; height: 24px; text-align: center;\">Ocasionalmente franca<\/td>\n<td style=\"width: 160px; text-align: center; height: 24px;\">2<\/td>\n<\/tr>\n<tr style=\"height: 24px;\">\n<td style=\"width: 126px; height: 24px; text-align: center;\">Usualmente franca<\/td>\n<td style=\"width: 160px; text-align: center; height: 24px;\">3<\/td>\n<\/tr>\n<tr style=\"height: 24px;\">\n<td style=\"width: 268px; height: 120px;\" rowspan=\"5\">Estado general<\/td>\n<td style=\"width: 126px; height: 24px; text-align: center;\">Muy bueno<\/td>\n<td style=\"width: 160px; text-align: center; height: 24px;\">0<\/td>\n<\/tr>\n<tr style=\"height: 24px;\">\n<td style=\"width: 126px; height: 24px; text-align: center;\">Ligeramente disminuido<\/td>\n<td style=\"width: 160px; text-align: center; height: 24px;\">1<\/td>\n<\/tr>\n<tr style=\"height: 24px;\">\n<td style=\"width: 126px; height: 24px; text-align: center;\">Pobre<\/td>\n<td style=\"width: 160px; text-align: center; height: 24px;\">2<\/td>\n<\/tr>\n<tr style=\"height: 24px;\">\n<td style=\"width: 126px; height: 24px; text-align: center;\">Muy pobre<\/td>\n<td style=\"width: 160px; text-align: center; height: 24px;\">3<\/td>\n<\/tr>\n<tr style=\"height: 24px;\">\n<td style=\"width: 126px; height: 24px; text-align: center;\">Terrible<\/td>\n<td style=\"width: 160px; text-align: center; height: 24px;\">4<\/td>\n<\/tr>\n<tr style=\"height: 24px;\">\n<td style=\"width: 268px; height: 24px;\">Caracter\u00edsticas extracol\u00f3nicas<\/td>\n<td style=\"width: 126px; height: 24px;\"><\/td>\n<td style=\"width: 160px; height: 24px; text-align: center;\">\u00a01 por manifestaci\u00f3n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>&nbsp;<\/p>\n<p><strong>\u00cdndice endosc\u00f3pico de severidad de la colitis ulcerosa<\/strong><\/p>\n<table style=\"border-collapse: collapse; width: 100%;\" border=\"1\">\n<tbody>\n<tr>\n<td><strong>Descriptor <\/strong><\/td>\n<td><strong>Puntos de anclaje a escala Likert<\/strong><\/td>\n<td><strong>Definiciones<\/strong><\/td>\n<\/tr>\n<tr>\n<td rowspan=\"3\">Patr\u00f3n vascular<\/td>\n<td>0 = normal<\/td>\n<td>Patr\u00f3n vascular normal con arborizaciones de capilares claramente definidas.<\/td>\n<\/tr>\n<tr>\n<td>1 = obliteraci\u00f3n irregular<\/td>\n<td>Obliteraci\u00f3n irregular del patr\u00f3n vascular<\/td>\n<\/tr>\n<tr>\n<td>2 = obliterado<\/td>\n<td>P\u00e9rdida completa del patr\u00f3n vascular<\/td>\n<\/tr>\n<tr>\n<td rowspan=\"4\">Sangrado<\/td>\n<td>0 = no<\/td>\n<td>Sin sangre visible<\/td>\n<\/tr>\n<tr>\n<td>1 = mucosa<\/td>\n<td>Manchas o vetas de sangre coagulada en la superficie de la mucosa, que se pueden lavar<\/td>\n<\/tr>\n<tr>\n<td>2 = luminal leve<\/td>\n<td>Algo de sangre l\u00edquida libre en la luz<\/td>\n<\/tr>\n<tr>\n<td>3 = luminal moderada o severa<\/td>\n<td>Sangre franca en la luz o exudaci\u00f3n visible de la mucosa despu\u00e9s del lavado o exudaci\u00f3n visible de una mucosa hemorr\u00e1gica<\/td>\n<\/tr>\n<tr>\n<td rowspan=\"4\">Erosiones y \u00falceras<\/td>\n<td>0 = no<\/td>\n<td>Mucosa normal, sin \u00falceras visibles ni erosiones.<\/td>\n<\/tr>\n<tr>\n<td>1 = erosiones<\/td>\n<td>Peque\u00f1os defectos en la mucosa (\u22645 mm), blanco o amarillo, borde plano<\/td>\n<\/tr>\n<tr>\n<td>2 = \u00falcera superficial<\/td>\n<td>Defectos m\u00e1s grandes en la mucosa (&gt; 5 mm), cubiertos de fibrina discreta, superficiales<\/td>\n<\/tr>\n<tr>\n<td>3 = \u00falcera profunda<\/td>\n<td>Defectos excavados m\u00e1s profundos en la mucosa, con un borde ligeramente elevado<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>&nbsp;<\/p>\n<p>Factores de mal pron\u00f3stico en la severidad de la colitis ulcerosa.<\/p>\n<ul>\n<li>Edad &lt;40 a\u00f1os al diagn\u00f3stico<\/li>\n<li>Colitis extensa<\/li>\n<li>Enfermedad endosc\u00f3pica grave (subscore endosc\u00f3pico Mayo 3, UCEIS \u2265 7)<\/li>\n<li>Hospitalizaci\u00f3n por colitis<\/li>\n<li>PCR elevada<\/li>\n<li>Alb\u00famina s\u00e9rica baja<\/li>\n<\/ul>\n<p>Cuanto mayor es el n\u00famero de factores de mal pron\u00f3stico, peor es el pron\u00f3stico medido por la probabilidad de colectom\u00eda.<\/p>\n<p>&nbsp;<\/p>\n<p><strong>Bibliograf\u00eda:<\/strong><\/p>\n<ol>\n<li>Rubin DT, Ananthakrishnan AN, Siegel CA, Sauer BG, Long MD. ACG Clinical Guideline: Ulcerative Colitis in Adults.\u00a0Am J Gastroenterol. 2019 Mar;114(3):384-413. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/30840605\/\" target=\"_blank\" rel=\"noopener noreferrer\">[Medline]<\/a><\/li>\n<li>Matsuoka K, Kobayashi T, Ueno F, Matsui T, Hirai F, Inoue N, Kato J, Kobayashi K, Kobayashi K, Koganei K, Kunisaki R, Motoya S, Nagahori M, Nakase H, Omata F, Saruta M, Watanabe T, Tanaka T, Kanai T, Noguchi Y, Takahashi KI, Watanabe K, Hibi T, Suzuki Y, Watanabe M, Sugano K, Shimosegawa T. Evidence-based clinical practice guidelines for inflammatory bowel disease.\u00a0J Gastroenterol. 2018 Mar;53(3):305-353. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/29429045\/\" target=\"_blank\" rel=\"noopener noreferrer\">[Medline]<\/a><\/li>\n<li>Spence S, Zaghiyan K. Ulcerative Colitis. Surg Clin North Am. 2026 Feb;106(1):121-132. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/41241447\/\" target=\"_blank\" rel=\"noopener\">[Medline]<\/a><\/li>\n<\/ol>\n<p>&nbsp;<\/p>\n<p>Creado Sep 25, 2019<br \/>\nActualizado Feb 3, 2026.<\/p>\n\n<div style=\"font-size: 0px; height: 0px; line-height: 0px; margin: 0; padding: 0; clear: both;\"><\/div>","protected":false},"excerpt":{"rendered":"<p>La colitis ulcerosa (CU) es una afecci\u00f3n inflamatoria cr\u00f3nica mediada por el sistema inmunitario del intestino grueso que con frecuencia se asocia con inflamaci\u00f3n del recto, pero a menudo se extiende de manera proximal para involucrar \u00e1reas adicionales del colon. Una vez que se hace un diagn\u00f3stico de CU, es importante determinar la gravedad de [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_lmt_disableupdate":"no","_lmt_disable":"no","_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"footnotes":""},"categories":[53],"tags":[217,58,60,59,222,35,2432],"class_list":["post-2114","post","type-post","status-publish","format-standard","hentry","category-gastroenterology","tag-actividad","tag-activity","tag-colitis","tag-index","tag-indice","tag-ulcerative","tag-ulcerosa"],"modified_by":"Guillermo Firman","_links":{"self":[{"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/posts\/2114","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/comments?post=2114"}],"version-history":[{"count":3,"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/posts\/2114\/revisions"}],"predecessor-version":[{"id":10615,"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/posts\/2114\/revisions\/10615"}],"wp:attachment":[{"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/media?parent=2114"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/categories?post=2114"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/tags?post=2114"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}