Interpretation
| Result | Meaning |
|---|---|
| Mild | ≤4 stools/day, little or no blood, no systemic toxicity |
| Moderate | Between mild and severe |
| Severe | ≥6 bloody stools/day + ≥1 of: T >37.8 °C, HR >90, Hb <10.5 g/dL, ESR >30 (or CRP >30) |
Formula
Severe = ≥6 bloody stools/day AND ≥1 of: temperature >37.8 °C, pulse >90/min, Hb <10.5 g/dL, ESR >30 mm/h (modified: CRP >30 mg/L). Mild = ≤4 stools/day, small or no blood, no systemic signs. Moderate = in between.
Clinical pearls
- This uses the modern operational definition (ECCO): one systemic sign suffices; the 1955 paper described severe attacks with all features.
- On day 3 of IV steroids, >8 stools/day or 3–8 stools with CRP >45 mg/L (Travis) predicts ~85% colectomy.
- ESR and CRP are optional; if neither is entered they are treated as not elevated.
Examples
truelove witts 8 bloody stools hr 105 temp 37.5 hb 11Is this severe UC? 3 stools a day, a little blood, temperature 36.8, pulse 75, Hb 13truelove 5 bms blood hr 95 temp 37 hgb 12 crp 20
FAQ
What is acute severe ulcerative colitis?
Six or more bloody stools a day plus at least one of fever >37.8 °C, pulse >90, hemoglobin <10.5 g/dL or ESR >30 mm/h (CRP >30 mg/L).
What happens with acute severe UC?
Admission, IV corticosteroids, VTE prophylaxis, stool infection testing and day-3 assessment for infliximab or ciclosporin rescue or colectomy.