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Mayo Score/Disease Activity Index (DAI) for Ulcerative Colitis

Composite clinical, endoscopic, and global-assessment severity index for ulcerative colitis.

Mayo Score/Disease Activity Index (DAI) for Ulcerative Colitis
Stool frequency (vs. patient's normal)
Rectal bleeding
Endoscopic findings
Physician's global assessment
Result0/12

Consistent with clinical remission (if no individual subscore >1).

Mayo score
0

When to use

  • Grading severity of ulcerative colitis and assessing response to therapy in clinical practice and trials, using stool frequency, rectal bleeding, endoscopy, and physician global assessment.

Formula

Mayo score = stool frequency(0-3) + rectal bleeding(0-3) + endoscopic findings(0-3) + physician's global assessment(0-3). Range 0-12. 0-2 = remission; 3-5 = mild; 6-10 = moderate; 11-12 = severe.

Pearls and pitfalls

  • The endoscopic subscore is the component most directly tied to mucosal healing, an important treatment target.
  • A partial Mayo score (excluding endoscopy) is often used for rapid clinical follow-up between endoscopies.

References

  1. 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):1625-9.