Ulcerative colitis classification

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

The inflammatory bowel disease (IBD) is divided primarily into ulcerative colitis and Crohn's disease. Some cases which depict overlapping features of both ulcerative colitis and Crohn's disease can be classified as intermediate colitis.

Classification

The inflammatory bowel disease (IBD) is divided primarily into ulcerative colitis and Crohn's disease. Some cases which depict overlapping features of both ulcerative colitis and Crohn's disease can be classified as intermediate colitis. Depending on the location of involved are with respect the descending colon, ulcerative colitis can be classified as proximal or distal. Based on the severity, ulcerative colitis can be classified into mild, moderate, severe or fulminant.

Classification of Ulcerate Colitis based on Location

Ulcerative colitis can be classified as follows based on the location of involvement of the colon:

• Distal
  • Limited below the descending colon
  • Topical therapy can be used
• Proximal
  • Extends proximal to the descending colon
  • Systemic therapy is required

Classification of Ulcerate Colitis based on Severity

• Mild
  • < 4 loose stools per day (+/- blood)
  • No dehydration
  • Mild crampy pain
  • No fever
  • Normal hemoglobin
  • Normal ESR
• Moderate

**> 4 loose stools per day (+/- blood) 

• • Mild dehydration
  • Abdominal pain that is not severe
  • Low grade fever
  • Mild anemia not requiring blood transfusions
• Severe
  • ≥6 loose bloody stools per day
  • Moderate to severe dehydration
  • Severe abdominal cramps
  • High fever (temperature ≥37.5ºC)
  • HR ≥90 beats/minute
  • Hemoglobin <10.5 g/dL
  • Elevated ESR (≥30 mm/hour)
  • Rapid weight loss
• Fulminant
  • >10 loose stools per day
  • Continuous bleeding
  • Severe dehydration
  • Severe abdominal pain
  • Abdominal distension
  • High fever (temperature ≥37.5ºC)
  • HR ≥90 beats/minute
  • Hemoglobin <10.5 g/dL
  • Elevated ESR (≥30 mm/hour)
  • Rapid weight loss