{"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\/ulcerative-colitis-activity\/","title":{"rendered":"Ulcerative Colitis Activity Index"},"content":{"rendered":"<div class=\"99c380e4b4a7b96c35d7ddf7dcb434e8\" 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>Ulcerative colitis (UC) is a chronic immune-mediated inflammatory condition of the large intestine that is frequently associated with inflammation of the rectum but often extends proximally to involve additional areas of the colon. Once a diagnosis of UC is made, determining the severity of disease becomes important. <!--more--><\/p>\n<p><strong>Proposed American College of Gastroenterology Ulcerative Colitis Activity Index<\/strong><\/p>\n<table style=\"border-collapse: collapse; width: 100%;\" border=\"1\">\n<tbody>\n<tr>\n<td style=\"width: 26.862%;\"><\/td>\n<td style=\"text-align: center; width: 16.8498%;\">Remission<\/td>\n<td style=\"text-align: center; width: 16.8498%;\">Mild<\/td>\n<td style=\"text-align: center; width: 17.4603%;\">Moderate-severe<\/td>\n<td style=\"text-align: center; width: 21.8559%;\">Fulminant<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 26.862%;\">Stools (no.\/d)<\/td>\n<td style=\"text-align: center; width: 16.8498%;\">Formed stools<\/td>\n<td style=\"text-align: center; width: 16.8498%;\">&lt;4<\/td>\n<td style=\"text-align: center; width: 17.4603%;\">&gt;6<\/td>\n<td style=\"text-align: center; width: 21.8559%;\">&gt;10<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 26.862%;\">Blood in stools<\/td>\n<td style=\"text-align: center; width: 16.8498%;\">None<\/td>\n<td style=\"text-align: center; width: 16.8498%;\">Intermittent<\/td>\n<td style=\"text-align: center; width: 17.4603%;\">Frequent<\/td>\n<td style=\"text-align: center; width: 21.8559%;\">Continuous<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 26.862%;\">Urgency<\/td>\n<td style=\"text-align: center; width: 16.8498%;\">None<\/td>\n<td style=\"text-align: center; width: 16.8498%;\">Mild, occasional<\/td>\n<td style=\"text-align: center; width: 17.4603%;\">Often<\/td>\n<td style=\"text-align: center; width: 21.8559%;\">Continuous<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 26.862%;\">Hemoglobin<\/td>\n<td style=\"text-align: center; width: 16.8498%;\">Normal<\/td>\n<td style=\"text-align: center; width: 16.8498%;\">Normal<\/td>\n<td style=\"text-align: center; width: 17.4603%;\">75% of normal<\/td>\n<td style=\"text-align: center; width: 21.8559%;\">Transfusion required<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 26.862%;\">ESR<\/td>\n<td style=\"text-align: center; width: 16.8498%;\">&lt;30<\/td>\n<td style=\"text-align: center; width: 16.8498%;\">&lt;30<\/td>\n<td style=\"text-align: center; width: 17.4603%;\">&gt;30<\/td>\n<td style=\"text-align: center; width: 21.8559%;\">&gt;30<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 26.862%;\">CRP (mg\/L)<\/td>\n<td style=\"text-align: center; width: 16.8498%;\">Normal<\/td>\n<td style=\"text-align: center; width: 16.8498%;\">Elevated<\/td>\n<td style=\"text-align: center; width: 17.4603%;\">Elevated<\/td>\n<td style=\"text-align: center; width: 21.8559%;\">Elevated<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 26.862%;\">FC (\u00b5g\/g)<\/td>\n<td style=\"text-align: center; width: 16.8498%;\">&lt;150\u2013200<\/td>\n<td style=\"text-align: center; width: 16.8498%;\">&gt;150\u2013200<\/td>\n<td style=\"text-align: center; width: 17.4603%;\">&gt;150\u2013200<\/td>\n<td style=\"text-align: center; width: 21.8559%;\">&gt;150\u2013200<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 26.862%;\">Endoscopy (Mayo subscore)<\/td>\n<td style=\"text-align: center; width: 16.8498%;\">0-1<\/td>\n<td style=\"text-align: center; width: 16.8498%;\">1<\/td>\n<td style=\"text-align: center; width: 17.4603%;\">2-3<\/td>\n<td style=\"text-align: center; width: 21.8559%;\">3<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 26.862%;\">UCEIS<\/td>\n<td style=\"text-align: center; width: 16.8498%;\">0-1<\/td>\n<td style=\"text-align: center; width: 16.8498%;\">2-4<\/td>\n<td style=\"text-align: center; width: 17.4603%;\">5-8<\/td>\n<td style=\"text-align: center; width: 21.8559%;\">7-8<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>The above factors are general guides for disease activity. With the exception of\u00a0 remission, a patient does not need to have all the factors to be considered in a specific category.<br \/>\nCRP, C-reactive protein; ESR, erythrocyte sedimentation rate; FC, fecal calprotectin; UCEIS, Ulcerative Colitis Endoscopic Index of Severity<\/p>\n<p><strong>Mayo score for ulcerative colitis activity<\/strong><\/p>\n<table style=\"border-collapse: collapse; width: 100%;\" border=\"1\">\n<tbody>\n<tr>\n<td>Parameter<\/td>\n<td>Subscore (0\u20133)<\/td>\n<\/tr>\n<tr>\n<td>Stool frequency<\/td>\n<td>0 = normal number of stools<br \/>\n1 = 1\u20132 stools more than normal<br \/>\n2 = 3\u20134 stools more than normal<br \/>\n3 = 5 or more stools more than normal<\/td>\n<\/tr>\n<tr>\n<td>Rectal bleeding<\/td>\n<td>0 = no blood seen<br \/>\n1 = streaks of blood with stool less than one-half of the time<br \/>\n2 = obvious blood with stool most of the time<br \/>\n3 = blood alone passed without stool<\/td>\n<\/tr>\n<tr>\n<td>Findings on endoscopy<\/td>\n<td>0 = normal or inactive disease<br \/>\n1 = mild disease (erythema, decreased vascular pattern, and mild friability)<br \/>\n2 = moderate disease (marked erythema, lack of vascular pattern, friability, and erosions)<br \/>\n3 = severe disease (spontaneous bleeding and ulcerations)<\/td>\n<\/tr>\n<tr>\n<td>Physician\u2019s global<br \/>\nassessment<\/td>\n<td>0 = normal<br \/>\n1 = mild disease<br \/>\n2 = moderate disease<br \/>\n3 = severe disease<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p><strong>Simple Clinical Colitis Activity Index<\/strong><\/p>\n<table style=\"border-collapse: collapse; width: 100%;\" border=\"1\">\n<tbody>\n<tr>\n<td style=\"width: 404px;\" colspan=\"2\">Symptom<\/td>\n<td style=\"width: 160px; text-align: center;\">Score<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 268px;\" rowspan=\"4\">Bowel frequency (d)<\/td>\n<td style=\"width: 126px; text-align: center;\">1-3<\/td>\n<td style=\"width: 160px; text-align: center;\">0<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 126px; text-align: center;\">4-6<\/td>\n<td style=\"width: 160px; text-align: center;\">1<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 126px; text-align: center;\">7-9<\/td>\n<td style=\"width: 160px; text-align: center;\">2<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 126px; text-align: center;\">9+<\/td>\n<td style=\"width: 160px; text-align: center;\">3<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 268px;\" rowspan=\"3\">Bowel frequency (night)<\/td>\n<td style=\"width: 126px; text-align: center;\">0<\/td>\n<td style=\"width: 160px; text-align: center;\">0<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 126px; text-align: center;\">1-3<\/td>\n<td style=\"width: 160px; text-align: center;\">1<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 126px; text-align: center;\">4-6<\/td>\n<td style=\"width: 160px; text-align: center;\">2<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 268px;\" rowspan=\"4\">Urgency of defecation<\/td>\n<td style=\"width: 126px; text-align: center;\">None<\/td>\n<td style=\"width: 160px; text-align: center;\">0<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 126px; text-align: center;\">Hurry<\/td>\n<td style=\"width: 160px; text-align: center;\">1<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 126px; text-align: center;\">Immediate<\/td>\n<td style=\"width: 160px; text-align: center;\">2<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 126px; text-align: center;\">Incontinence<\/td>\n<td style=\"width: 160px; text-align: center;\">3<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 268px;\">Blood in stool<\/td>\n<td style=\"width: 126px; text-align: center;\">None<\/td>\n<td style=\"width: 160px; text-align: center;\">0<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 268px;\"><\/td>\n<td style=\"width: 126px; text-align: center;\">Trace<\/td>\n<td style=\"width: 160px; text-align: center;\">1<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 268px;\"><\/td>\n<td style=\"width: 126px; text-align: center;\">Occasionally frank<\/td>\n<td style=\"width: 160px; text-align: center;\">2<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 268px;\"><\/td>\n<td style=\"width: 126px; text-align: center;\">Usually frank<\/td>\n<td style=\"width: 160px; text-align: center;\">3<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 268px;\">General well-being<\/td>\n<td style=\"width: 126px; text-align: center;\">Very well<\/td>\n<td style=\"width: 160px; text-align: center;\">0<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 268px;\"><\/td>\n<td style=\"width: 126px; text-align: center;\">Slightly below par<\/td>\n<td style=\"width: 160px; text-align: center;\">1<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 268px;\"><\/td>\n<td style=\"width: 126px; text-align: center;\">Poor<\/td>\n<td style=\"width: 160px; text-align: center;\">2<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 268px;\"><\/td>\n<td style=\"width: 126px; text-align: center;\">Very poor<\/td>\n<td style=\"width: 160px; text-align: center;\">3<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 268px;\"><\/td>\n<td style=\"width: 126px; text-align: center;\">Terrible<\/td>\n<td style=\"width: 160px; text-align: center;\">4<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 268px;\">Extracolonic features<\/td>\n<td style=\"width: 126px;\"><\/td>\n<td style=\"width: 160px; text-align: center;\">\u00a01 per manifestation<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>&nbsp;<\/p>\n<p><strong>Ulcerative Colitis Endoscopic Index of Severity<\/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>Likert scale anchor points<\/strong><\/td>\n<td><strong>Definitions<\/strong><\/td>\n<\/tr>\n<tr>\n<td rowspan=\"3\">Vascular pattern<\/td>\n<td>0 = normal<\/td>\n<td>Normal vascular pattern with arborizations of capillaries clearly defined<\/td>\n<\/tr>\n<tr>\n<td>1 = patchy obliteration<\/td>\n<td>Patchy obliteration of vascular pattern<\/td>\n<\/tr>\n<tr>\n<td>2 = obliterated<\/td>\n<td>Complete loss of vascular pattern<\/td>\n<\/tr>\n<tr>\n<td rowspan=\"4\">Bleeding<\/td>\n<td>0 = none<\/td>\n<td>No visible blood<\/td>\n<\/tr>\n<tr>\n<td>1 = mucosal<\/td>\n<td>Spots or streaks of coagulated blood on the mucosa surface, which can be washed off<\/td>\n<\/tr>\n<tr>\n<td>2 = luminal mild<\/td>\n<td>Some free liquid blood in the lumen<\/td>\n<\/tr>\n<tr>\n<td>3 = luminal moderate or severe<\/td>\n<td>Frank blood in the lumen or visible oozing from the mucosa after washing or visible oozing from a hemorrhagic mucosa<\/td>\n<\/tr>\n<tr>\n<td rowspan=\"4\">Erosions and ulcers<\/td>\n<td>0 = none<\/td>\n<td>Normal mucosa, no visible ulcers or erosions<\/td>\n<\/tr>\n<tr>\n<td>1 = erosions<\/td>\n<td>Small defects in the mucosa (\u22645 mm), white or yellow, flat edge<\/td>\n<\/tr>\n<tr>\n<td>2 = superficial ulcer<\/td>\n<td>Larger defects in the mucosa (&gt;5 mm), discrete fibrin covered, remain superficial<\/td>\n<\/tr>\n<tr>\n<td>3 = deep ulcer<\/td>\n<td>Deeper excavated defects in the mucosa, with a slightly raised edge<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>&nbsp;<\/p>\n<p><strong>Poor prognostic factors in ulcerative colitis disease severity<\/strong><\/p>\n<ul>\n<li>Age &lt;40 yr at diagnosis<\/li>\n<li>Extensive colitis<\/li>\n<li>Severe endoscopic disease (Mayo endoscopic subscore 3, UCEIS \u2265 7)<\/li>\n<li>Hospitalization for colitis<\/li>\n<li>Elevated CRP<\/li>\n<li>Low serum albumin<\/li>\n<\/ul>\n<p>The greater the number of poor prognostic factors, the worse the prognosis as measured by the likelihood of colectomy.<\/p>\n<p>&nbsp;<\/p>\n<p><strong>References:<\/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>Created Sep 25, 2019<br \/>\nUp-date 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>Sorry, this entry is only available in Espa\u00f1ol.<\/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\/wp-json\/wp\/v2\/posts\/2114","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/comments?post=2114"}],"version-history":[{"count":3,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/2114\/revisions"}],"predecessor-version":[{"id":10615,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/2114\/revisions\/10615"}],"wp:attachment":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/media?parent=2114"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/categories?post=2114"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/tags?post=2114"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}