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Gut. Jul 1998; 43(1): 29–32.
PMCID: PMC1727189

A simple clinical colitis activity index


Background—The appropriate medical treatment of patients with ulcerative colitis is determined largely by the severity of symptoms. Hospital assessment of the severity of disease activity includes investigation of laboratory indices and sigmoidoscopic assessment of mucosal inflammation.
Aims—To develop a simplified clinical colitis activity index to aid in the initial evaluation of exacerbations of colitis.
Methods—The information for development of the simple index was initially evaluated in 63 assessments of disease activity in patients with ulcerative colitis where disease activity was evaluated using the Powell-Tuck Index (which includes symptoms, physical signs, and sigmoidoscopic appearance). The new index was then further evaluated in 113 assessments in a different group of patients, by comparison with a complex index utilising clinical and laboratory data, as well as five haematological and biochemical markers of disease severity.
Results—The newly devised Simple Clinical Colitis Activity Index, consisting of scores for five clinical criteria, showed a highly significant correlation with the Powell-Tuck Index (r=0.959, p<0.0001) as well as the complex index (r=0.924, p<0.0001) and all laboratory markers (p=0.0003 to p<0.0001).
Conclusions—This new Simple Colitis Activity Index shows good correlation with existing more complex scoring systems and therefore could be useful in the initial assessment of patients with ulcerative colitis.

Keywords: ulcerative colitis; disease activity

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Sinclair TS, Brunt PW, Mowat NA. Nonspecific proctocolitis in northeastern Scotland: a community study. Gastroenterology. 1983 Jul;85(1):1–11. [PubMed]
  • Devlin HB, Datta D, Dellipiani AW. The incidence and prevalence of inflammatory bowel disease in North Tees Health District. World J Surg. 1980;4(2):183–193. [PubMed]
  • Powell-Tuck J, Bown RL, Lennard-Jones JE. A comparison of oral prednisolone given as single or multiple daily doses for active proctocolitis. Scand J Gastroenterol. 1978;13(7):833–837. [PubMed]
  • Rao SS, Holdsworth CD, Read NW. Symptoms and stool patterns in patients with ulcerative colitis. Gut. 1988 Mar;29(3):342–345. [PMC free article] [PubMed]
  • Harvey RF, Bradshaw JM. A simple index of Crohn's-disease activity. Lancet. 1980 Mar 8;1(8167):514–514. [PubMed]
  • Seo M, Okada M, Yao T, Ueki M, Arima S, Okumura M. An index of disease activity in patients with ulcerative colitis. Am J Gastroenterol. 1992 Aug;87(8):971–976. [PubMed]
  • Seo M, Okada M, Yao T, Okabe N, Maeda K, Oh K. Evaluation of disease activity in patients with moderately active ulcerative colitis: comparisons between a new activity index and Truelove and Witts' classification. Am J Gastroenterol. 1995 Oct;90(10):1759–1763. [PubMed]
  • Cooke WT, Prior P. Determining disease activity in inflammatory bowel disease. J Clin Gastroenterol. 1984 Feb;6(1):17–25. [PubMed]
  • Kambe H, Yoshida T, Haraguchi Y, Iwashita T, Sakamoto A, Tanaka K. Quantification of disease activity in patients with ulcerative colitis. J Clin Gastroenterol. 1986 Dec;8(6):651–654. [PubMed]
  • TRUELOVE SC, WITTS LJ. Cortisone in ulcerative colitis; final report on a therapeutic trial. Br Med J. 1955 Oct 29;2(4947):1041–1048. [PMC free article] [PubMed]
  • Drossman DA, Li Z, Leserman J, Patrick DL. Ulcerative colitis and Crohn's disease health status scales for research and clinical practice. J Clin Gastroenterol. 1992 Sep;15(2):104–112. [PubMed]
  • Gomes P, du Boulay C, Smith CL, Holdstock G. Relationship between disease activity indices and colonoscopic findings in patients with colonic inflammatory bowel disease. Gut. 1986 Jan;27(1):92–95. [PMC free article] [PubMed]
  • Rachmilewitz D. Coated mesalazine (5-aminosalicylic acid) versus sulphasalazine in the treatment of active ulcerative colitis: a randomised trial. BMJ. 1989 Jan 14;298(6666):82–86. [PMC free article] [PubMed]
  • Rutegård I, Ahsgren L, Stenling R, Nilsson T. A simple index for assessment of disease activity in patients with ulcerative colitis. Hepatogastroenterology. 1990 Dec;37 (Suppl 2):110–112. [PubMed]

Figures and Tables

Figure 1
Scattergram showing the relation between the Powell-Tuck Index and the new Simple Clinical Colitis Activity Index (n=63, r=0.959, p<0.0001, Spearman's rank correlation).
Figure 2
Scattergram showing the relation between the complex disease activity index scores and the Simple Clinical Colitis Activity Index (n=110, r=0.924, p<0.0001, Spearman's rank correlation).

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