Mayo Score for Ulcerative Colitis Activity
Assesses ulcerative colitis (UC) disease activity using clinical and endoscopic findings. Guides treatment decisions including steroid use and biologics.
Score interpretation
Mayo Score 0–2: Ulcerative colitis in clinical remission.
→ Maintain on mesalazine (5-ASA) maintenance. Review 6-monthly. Surveillance colonoscopy as per BSG/NICE guidelines.
Mayo Score 3–5: Mildly active UC.
→ Increase 5-ASA dose. Add rectal 5-ASA. If inadequate response: oral prednisolone 40mg OD. Gastroenterology review.
Mayo Score 6–10: Moderately active UC.
→ Oral prednisolone 40mg tapering. CRP, FBC, albumin, stool cultures, C. diff. Consider biologic therapy (infliximab, vedolizumab) if steroid-dependent/refractory. Gastroenterology review.
Mayo Score 11–12: Severely active UC.
→ Admit. IV hydrocortisone 100mg QDS. Stool cultures including C. diff. Daily FBC, CRP, albumin, electrolytes. Flexible sigmoidoscopy. If no response by Day 3 → rescue therapy (infliximab or cyclosporin) or colectomy. Surgical review on admission.
Interpretation bands for the Mayo Score (UC). Apply clinical judgement and local guidance.
References
- Schroeder KW, Tremaine WJ, Ilstrup DM. Coated oral 5-aminosalicylic acid therapy for mildly to moderately active ulcerative colitis. N Engl J Med. 1987;317(26):1625–1629.
- NICE NG130. Ulcerative colitis: management. 2019.
Related
Curated clinical cross-links plus same-class fallbacks.
- Harvey-Bradshaw Index for Crohn's Disease · Inflammatory Bowel Disease
- Crohn's Disease Activity Index (CDAI) · Inflammatory Bowel Disease
- Truelove and Witts Severity Index for Ulcerative Colitis · Inflammatory Bowel Disease
- Ulcerative Colitis Endoscopic Index of Severity (UCEIS) · Inflammatory Bowel Disease
- Simplified Endoscopic Score for Crohn's Disease (SES-CD) · Inflammatory Bowel Disease
- Travis Criteria for Severe Ulcerative Colitis · Inflammatory Bowel Disease
- Prednisolone (Rheumatology) · Corticosteroid (oral) — bridge/anti-inflammatory
- Pindolol · Non-selective β-blocker (with intrinsic sympathomimetic activity)
- Dapsone · Anti-inflammatory / Antimicrobial
- Methotrexate (Dermatology — Psoriasis) · Disease-Modifying Antirheumatic / Immunosuppressant
- Colchicine · Anti-inflammatory — Neutrophilic Dermatoses / Vasculitis
- Prednisolone (Systemic) · Systemic Corticosteroid — Acute Dermatoses
- Upper GI Bleeding · BSG Guidelines 2019; NICE NG141
- Lower Gastrointestinal Bleed · NICE; BSG; ACPGBI — Commissioning Guide
- Acute Pancreatitis · NICE; IAP/APA; ACPGBI — CG104
- Sepsis Screening and Sepsis Six · UK Sepsis Trust; NICE NG51; Surviving Sepsis Campaign 2021
- Unintentional Weight Loss Workup · NICE NG12; BSG
- Chronic Fatigue Workup · NICE NG206; BMJ Best Practice
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.