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gi-hepatology

Harvey-Bradshaw Index (HBI) for Crohn Disease

Simple clinical index for assessing Crohn disease activity. Simplified version of the Crohn Disease Activity Index (CDAI), not requiring a diary. Scores ≥5 indicate active disease.

Used in: Inflammatory Bowel Disease

Score interpretation

Remission

→ HBI 0–4: Clinical remission. Continue maintenance therapy; monitor CRP and faecal calprotectin. Annual review if stable; colonoscopic mucosal healing assessment as per guidelines.

Mild Activity

→ HBI 5–7: Mild Crohn disease activity. Review adherence to maintenance therapy; consider step-up: budesonide or 5-ASA for colonic Crohn; check CRP and calprotectin; gastroenterology review.

Moderate Activity

→ HBI 8–16: Moderate Crohn disease activity. Systemic steroids (prednisolone 40 mg tapering); consider biologic escalation (anti-TNF/anti-integrin); surgical review if complications.

Severe Activity

→ HBI >16: Severe Crohn disease activity. Hospital admission; IV hydrocortisone; nil by mouth if obstruction/perforation suspected; urgent IBD team and surgical review; CT abdomen.

Interpretation bands for the Harvey-Bradshaw Index. Apply clinical judgement and local guidance.

References

Related

Curated clinical cross-links plus same-class fallbacks.

Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.