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Truelove and Witts Severity Index for Ulcerative Colitis
Classic clinical severity classification for ulcerative colitis flares.
Truelove and Witts Severity Index for Ulcerative Colitis
Bowel movements per day
Temperature >37.8°C
Heart rate >90/min
Hemoglobin <10.5 g/dL
ESR >30 mm/hr (or CRP >30 mg/L)
ResultMild
Meets criteria for mild ulcerative colitis.
- Systemic toxicity features
- 0 of 4
When to use
- Classifying the severity of an ulcerative colitis flare at initial assessment to guide the need for hospitalisation and intravenous therapy.
Formula
Severe: ≥6 bowel movements/day with blood, plus ≥1 of fever >37.8°C, pulse >90/min, haemoglobin <10.5 g/dL, or ESR >30. Mild: <4 stools/day with none of the systemic features. Moderate: intermediate.
Pearls and pitfalls
- Still the basis for defining acute severe ulcerative colitis (Truelove & Witts severe criteria) used to trigger inpatient rescue-therapy pathways today.