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 0–2 with no individual subscore above 1: clinical remission. A total of 2 or less with any subscore of 2 or more is not 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 (adults: 40mg OD). Gastroenterology review. Children: use a children's formulary.
Mayo Score 6–10: Moderately active UC.
→ Adults: oral prednisolone 40mg tapering. CRP, FBC, albumin, stool cultures, C. diff. Consider biologic therapy (infliximab, vedolizumab) if steroid-dependent/refractory. Gastroenterology review. Children: use a children's formulary.
Mayo Score 11–12: Severely active UC.
→ Admit. IV hydrocortisone (adults: 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. Children: use a children's formulary.
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.
