Severity

The severity of ulcerative colitis can be assessed on the basis of:

• bowel frequency - less than four motions per day is considered mild, more than six is severe.
• rectal bleeding
• temperature - patients with mild disease are apyrexial, those with severe disease may be higher than 37.8øC
• haemoglobin of less than 10.5 is considered severe, greater than 11 is mild
• ESR of less than 30mm per hour is mild, greater than this is severe
• tachycardia is related to severity
• low albumin - below 30g per litre implies severe disease (1)

So the severity of disease activity of Ulcerative colitis can be graded as:

• mild
  • less than four stools daily, with or without blood
  • without systemic disturbance
  • normal ESR and CRP values
• moderate
  • four to six stools a day with minimal systemic disturbance
• severe
  • more than six stools a day, containing blood
  • and evidence of systemic disturbance (fever, tachycardia, anaemia, or hypoalbuminaemia) (2)

Reference:

• (1) Langan RC et al. Ulcerative colitis: diagnosis and treatment. Am Fam Physician. 2007;76(9):1323-30
• (2) Collins P, Rhodes J. Ulcerative colitis: diagnosis and management. BMJ. 2006;333(7563):340-3