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Mayo Scoring System for Assessment of Ulcerative Colitis

Which one should you choose?  "The partial Mayo score performed as well as the full Mayo score to identify patient perceived clinical response. " 1  The Partial Mayo clinic score can easily be performed at the bedside for not only initial assessment, but also follow-up visits to assess the impact of clinical interventions.
Select Mayo Scoring system preference:  
Full Mayo Score (Includes endoscopic findings)

Partial Mayo Score (eliminates endoscopy)
1. Stool frequency (per day): 1
 
2. Rectal bleeding  (indicate the most severe bleeding of the day):

[Assigning a score of 3 requires patients to have >/=50% of bowel movement accompanied by visible blood and 1+ bowel movement with blood alone.]2
3. Mucosal appearance at endoscopy

[Ignore if you selected Partial Mayo Score]
4. Physician’s Global Assessment:*

[*The physician’s Global Assessment acknowledges the sub scores, the daily record of abdominal discomfort and functional assessment and other observations such as physical findings, and the patient’s performance status.]2

Background Info

Scoring:

Stool Frequency
0 = Normal
1 = 1-2 stools/day more than normal
2 = 3-4 stools/day more thannormal
3 = 5 or more stools/day than normal

Rectal bleeding
0 = None
1 = Visible blood with stool less than half the time
2 = Visible blood with stool half of the time or more
3 = Passing blood alone

Mucosal appearance at endoscopy
0 = Normal or inactive disease
1 = Mild disease (erythema, decreased vascular pattern, mild friability
2 = Moderate disease (marked erythema, absent vascular pattern, friability, erosions)
3 = Severe disease (spontaneous bleeding, ulceration)

Physician rating of disease activity
0 = Normal
1 = Mild
2 = Moderate
3 = Severe


Assessment based on Scoring:
Full Mayo Index Score:
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Maximum score: 12.  Higher scores indicate more severe disease (Ulcerative colitis).  A critical component of this score are the endoscopic findings.  Patient's with lower scores but with an endoscopic score of 2 or greater are considered more severe regardless of the final score.


Partial Mayo Index Score
Mucosal appearance at endoscopy is not included.
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Remission
: 0-1 [Remission defined as patient assessment of disease activity as perfect or very good (minimal symptoms).]3
Mild Disease: 2-4
Moderate Disease: 5-6
Severe Disease: 7-9


References

  1. Rutgeerts P, Sandborn WJ, Feagan BG, Reinisch W, et al. Infliximab for induction and maintenance therapy for ulcerative colitis. N Engl J Med. 2005; 353 (23): 2462-2476.
    https://www.ncbi.nlm.nih.gov/pubmed/16339095


  2. Schroeder KW, Tremaine WJ, Ilstrup DM. Coated oral 5-aminosalcylic acid therapy for mildly to moderately active ulcerative colitis. N Eng J Med 1987; 317 (26): 1625-1629.
    https://www.ncbi.nlm.nih.gov/pubmed/3317057


  3. Lewis JD, Chuai S, Nessel L, Lichtenstein GR, Aberra FN, Ellenberg JH. Use of the noninvasive components of the Mayo score to assess clinical response in ulcerative colitis. Inflamm Bowel Dis. 2008; 14 (12): 1660-1666.
    https://www.ncbi.nlm.nih.gov/pubmed/18623174

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