Mayo Score Disease Activity Index (DAI) for Ulcerative Colitis

Evaluates the severity of ulcerative colitis to help with monitoring treatment effectiveness.

Refer to the text below the calculator for more information about the use of the DAI in clinical trials and routine practice.


The Mayo Score for Ulcerative Colitis standardizes the severity of a patient's ulcerative colitis symptoms, which in turn helps clinicians assess response to treatment and adapt it accordingly.

Please note this is not a tool to diagnose UC, nor to solely decide need for hospital admission or surgical therapy.


The Mayo Score ranges from 0 to 12 with higher scores indicating worse severity. Patient score is in reference to their previous scores to determine change in function.

Often used in clinical trials, evolutions in the Mayo Score may be interpreted as follows:

  • Remission is defined as total scores of 2 or less with either of four items scoring no more than 1 point.
  • Mucosal healing is defined as an endoscopic score of 0 or 1.

1

Stool Frequency

2

Rectal Bleeding

A score of 3 for bleeding required patients to have at least 50% of bowel motions accompanied by visible blood and at least one bowel motion with blood alone.
3

Endoscopic Findings

4

Physician Global Assessment

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Mayo Score Disease Activity Index (DAI) Explained

The DAI is a useful and straightforward to administer tool that can help clinicians with the management of ulcerative colitis, with respect to changing or stopping medication. Please note this is not a tool to diagnose UC, nor to solely decide need for hospital admission or surgical therapy.

There are four items in the score, each rated from 0 to 3, where 3 means highest severity.

Mayo Score Disease Activity Index (DAI) Answer choices Pts
Stool Frequency Patient reports a normal number of daily stools 0
One to two more stools than normal 1
Three to four more stools than normal 2
Five or more stools than usual 3
Rectal Bleeding* None 0
Blood streaks seen in the stool <½ the time 1
Blood in most stools 2
Pure blood passed 3
Endoscopic Findings Normal or inactive colitis seen 0
Mild colitis: mild friability, erythema, decrease in vascuality 1
Moderate colitis: friability, marked erythema, vascular pattern absent, erosions seen 2
Severe colitis: ulcerations and spontaneous bleeding 3
Physician Global Assessment Normal 0
Mild colitis 1
Moderate colitis 2
Severe colitis 3

*A score of 3 for bleeding required patients to have at least 50% of bowel motions accompanied by visible blood and at least one bowel motion with blood alone.

The Mayo Score ranges from 0 to 12 with higher scores indicating worse severity. Patient score is in reference to their previous scores to determine change in function.

Originally developed in 1987 during a clinical trial by Schroeder et al. for pH dependent 5-ASA (Asacol), the Mayo Score for Ulcerative Colitis standardizes the severity of a patient's ulcerative colitis symptoms, which in turn helps clinicians assess response to treatment and adapt it accordingly.

Often used in clinical trials, evolutions in the Mayo DAI Score may be interpreted as follows:

  • Remission is defined as total scores of 2 or less with either of four items scoring no more than 1 point.
  • Mucosal healing is defined as an endoscopic score of 0 or 1.

The score was found to closely correlate with quality of life in the study by Irvine et al.

 

References

Original reference

Schroeder KW, Tremaine WJ, Ilstrup DM. Coated oral 5-aminosalicylic acid therapy for mildly to moderately active ulcerative colitis. A randomized study. N Engl J Med. 1987; 317(26):1625-9.

Validation

Travis SP, Schnell D, Krzeski P, Abreu MT, Altman DG, Colombel JF, Feagan BG, Hanauer SB, Lichtenstein GR, Marteau PR, Reinisch W, Sands BE, Yacyshyn BR, Schnell P, Bernhardt CA, Mary JY, Sandborn WJ. Reliability and initial validation of the ulcerative colitis endoscopic index of severity. Gastroenterology. 2013; 145(5):987-95.

Other references

Manginot C, Baumann C, Peyrin-Biroulet L. An endoscopic Mayo score of 0 is associated with a lower risk of colectomy than a score of 1 in ulcerative colitis. Gut. 2015; 64(7):1181-2.

Paine ER. Colonoscopic evaluation in ulcerative colitis. Gastroenterol Rep (Oxf). 2014; 2(3):161-8.

Lewis JD, Chuai S, Nessel L, Lichtenstein GR, Aberra FN, Ellenberg JH. Use of the noninvasive components of the Mayo score to assess clinical response in ulcerative colitis. Inflamm Bowel Dis. 2008; 14(12):1660-6.


Specialty: Gastroenterology

System: Digestive

Year Of Study: 1987

Abbreviation: DAI

Article By: Denise Nedea

Published On: October 16, 2020

Last Checked: October 16, 2020

Next Review: October 16, 2025