Abstract
Colonoscopy is a gold standard in assessing disease severity of ulcerative colitis, and therefore efforts have been made in order to quantify the severity of inflammation by endoscopic indices. Most indices have been proposed to assess the efficacy of clinical trials, and therefore not been validated. Baron score, ulcerative colitis endoscopic index of severity (UCEIS), and ulcerative colitis colonoscopic index of severity (UCCIS) are validated. There are some scoring systems in which different factors are graded for each item separately [Baron score, Rachmilewitz score, endoscopic activity index (EAI, UCEIS and UCCIS), and others grading multiple aspects altogether (Matts’ endoscopic grading, the Mayo endoscopic subscore (MES)]. It is essential to understand both strength and weakness of each index and utilize appropriately, since different indices have been developed for different purposes. It should be also noted that none of these widely used indices takes extent of inflammation into account. Currently, MES is most widely used in clinical trials for its simplicity, and UCEIS may become more common in the future because of its lower inter-observer variability. Definition of mucosal healing in each index has not been established yet.
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