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Harvey-Bradshaw Index (Crohn's Disease)

The Harvey-Bradshaw Index scores Crohn's disease activity from well-being, abdominal pain, liquid stools per day, abdominal mass and complications. A score <5 indicates remission, 5–7 mild, 8–16 moderate and >16 severe disease; a fall of ≥3 points indicates clinical response.

General well-being (yesterday): Very well (0); Slightly below par (1); Poor (2); Very poor (3); Terrible (4)
Abdominal pain (yesterday): None (0); Mild (1); Moderate (2); Severe (3)
Number of liquid or soft stools (yesterday)
Abdominal mass: None (0); Dubious (1); Definite (2); Definite and tender (3)
Arthralgia (yes/no, +1)
Uveitis (yes/no, +1)
Erythema nodosum (yes/no, +1)
Aphthous ulcers (yes/no, +1)
Pyoderma gangrenosum (yes/no, +1)
Anal fissure (yes/no, +1)
New fistula (yes/no, +1)
Abscess (yes/no, +1)

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Interpretation

Result	Meaning
< 5	Remission
5–7	Mild
8–16	Moderate
> 16	Severe
Fall ≥3	Clinical response (≈ CDAI fall of 100)

Formula

HBI = well-being (0–4) + abdominal pain (0–3) + number of liquid stools yesterday + abdominal mass (0–3) + 1 per complication (arthralgia, uveitis, erythema nodosum, aphthous ulcers, pyoderma gangrenosum, anal fissure, new fistula, abscess)

Clinical pearls

Symptoms refer to the previous day.
HBI ≤4 corresponds to CDAI ≤150 (Vermeire 2010).
Symptom indices correlate poorly with endoscopic activity; confirm with CRP, calprotectin or endoscopy.

Examples

hbi slightly below par mild pain 4 liquid stools no mass arthralgia Harvey-Bradshaw index: feeling poor, moderate abdominal pain, 6 loose stools, definite mass, perianal abscess harvey bradshaw very well no pain 1 stool no mass

FAQ

What HBI score is remission?

A Harvey-Bradshaw Index below 5 (≤4) indicates clinical remission.

HBI or CDAI?

HBI uses only the previous day and needs no diary or hematocrit; it correlates well with CDAI (r ≈ 0.8).

Evidence

Hepatology & GI · Reviewed 2026-10-14 · Methodology