INFORMATION AND REFERENCES
The full Mayo Score evaluates ulcerative colitis stage, based on four parameters: stool frequency, rectal bleeding, endoscopic evaluation and Physician’s global assessment (1,2).
Each parameter of the score ranges from zero (normal or inactive disease) to 3 (severe activity).
The following table indicates, for each parameter, the input values with their respective scores.
|Parameter ||Clinical evaluation (single choice) ||Score |
|1. Stool frequency |
- normal number of stools
- 1-2 more than normal
- 3-4 more than normal
- ≥ 5 more than normal
|2. Rectal bleeding |
(indicate the most severe bleeding of the day)
- streaks of blood with stool in in less than half of the cases
- obvious blood with stools in most cases
- blood alone passes
|3. Endoscopic findings || |
- normal mucosa or inactive disease
- mild activity (erythema, decreased vascular pattern,
- moderate activity (marked erythema,
lack of vascular pattern, friability, erosions)
- severe activity (spontaneous bleeding, large ulcerations)
|4. Physician’s global assessment || |
- mild disease
- moderate disease
- severe disease
Calculation formula: sum of the scores of the four parameters.
Clinical response is defined as a decrease of at least 3 points and at least 30% versus baseline, which must include a decrease in the score for rectal bleeding of at least 1 point, or an absolute score for rectal bleeding not exceeding 1.
Decoding table (3)
|Score ||Decoding |
|0 - 2 ||remission |
(provided that no subscore for each single parameter is greater than 1)
|3 - 5 ||mild activity |
|6 - 10 ||moderate activity |
|> 10 ||severe activity |
Note: if the total score is 2, but achieved with only one subscore = 2 and the other three = 0, the computer will give as a result a score of 2 and the sentence: mild activity (single subscore = 2).
The subscore 3, "Endoscopic findings" can also be used on its own.
The following table shows the decoding for the endoscopic findings, with some example images.
|Mayo 0 |
normal mucosa or inactive disease
|Mayo 1 |
mild activity (erythema,
decreased vascular pattern,
|Mayo 2 |
lack of vascular pattern,
|Mayo 3 |
- Schroeder KW, Tremaine WJ, Ilstrup DM: Coated oral 5-aminosalcylic acid therapy for mildly to moderately active ulcerative colitis. N Eng J Med 1987; 317 (26): 1625-1629.
- Rutgeerts P, Sandborn WJ, Feagan BG, Reinisch W, et al. Infliximab for induction and maintenance therapy for ulcerative colitis. N Engl J Med. 2005; 353 (23): 2462-2476.
- Dhanda AD, Creed TJ, Greenwood R et al. Can Endoscopy Be Avoided in the Assessment of Ulcerative Colitis in Clinical Trials? Inflamm Bowel Dis 2012; 18 (11): 2056–2062.