Truelove and Witts Severity Index for Ulcerative Colitis
Simple clinical classification of ulcerative colitis severity. Identifies patients with severe colitis requiring hospitalisation and intensive treatment.
Score interpretation
≤ 4 bloody stools a day with no fever, tachycardia, anaemia or raised ESR.
→ Outpatient management; topical/oral 5-ASA; review in 2–4 weeks
Between mild and severe: > 4 stools a day, or systemic features without ≥ 6 stools a day.
→ Oral corticosteroids; close follow-up; consider early gastroenterology review; hospital if no improvement in 72h
Acute severe UC: ≥ 6 bloody stools a day plus at least one systemic feature.
→ Urgent hospital admission; IV hydrocortisone (adults: 100 mg 6-hourly); gastroenterology review within 24h; surgical standby. Children: use a children's formulary.
Interpretation bands for the Truelove & Witts. Apply clinical judgement and local guidance.
References
- Truelove SC, Witts LJ. Cortisone in ulcerative colitis: final report on a therapeutic trial. BMJ. 1955;2(4947):1041–1048.
Related
Curated clinical cross-links plus same-class fallbacks.
- Harvey-Bradshaw Index for Crohn's Disease · Inflammatory Bowel Disease
- Mayo Score for Ulcerative Colitis Activity · Inflammatory Bowel Disease
- Crohn's Disease Activity Index (CDAI) · 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
- Dapsone · Anti-inflammatory / Antimicrobial
- Methotrexate (Dermatology — Psoriasis) · Disease-Modifying Antirheumatic / Immunosuppressant
- Colchicine · Anti-inflammatory — Neutrophilic Dermatoses / Vasculitis
- Acetazolamide (Ménière's Disease) · Carbonic Anhydrase Inhibitor (Diuretic)
- Diclofenac · Non-Steroidal Anti-Inflammatory Drug (NSAID)
- Colchicine (Acute Gout) · Anti-Inflammatory (Microtubule Inhibitor)
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.
