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
(per day)
  • normal number of stools
  • 1-2 more than normal
  • 3-4 more than normal
  • ≥ 5 more than normal
 0
1
2
3
2. Rectal bleeding
(indicate the most severe bleeding of the day)
  • none
  • streaks of blood with stool in in less than half of the cases
  • obvious blood with stools in most cases
  • blood alone passes
 0
1
2
3
3. Endoscopic findings
  • normal mucosa or inactive disease
  • mild activity (erythema, decreased vascular pattern,
    mild friability)
  • moderate activity (marked erythema,
    lack of vascular pattern, friability, erosions)
  • severe activity (spontaneous bleeding, large ulcerations)
 0

1

2
3
4. Physician’s global assessment
  • normal
  • mild disease
  • moderate disease
  • severe disease
 0
1
2
3

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,
mild friability)
Mayo 2
moderate activity
(marked erythema,
lack of vascular pattern,
friability, erosions)
Mayo 3
severe activity
(spontaneous bleeding,
large ulcerations)
References
  • 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.