🩺 Truelove-Witts Ulcerative Colitis Severity
The Truelove and Witts criteria classify an acute ulcerative colitis flare as mild, moderate, or severe from bowel and systemic features.
Acute severe UC meeting the criteria is a medical emergency requiring admission, IV corticosteroids, and surgical co-review (original synthesis · not guideline verbatim).
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When to use
Select daily stool count, rectal bleeding, and four systemic markers; the tool returns the severity category and the number of systemic features present.
How it works
Severe = ≥6 bloody stools/day plus ≥1 of (temp >37.8°C, HR >90 bpm, Hb <105 g/L, ESR >30 mm/h). Mild = <4 stools/day with no systemic features. Otherwise moderate.
Key points
- Acute severe UC meeting the criteria is a medical emergency requiring admission, IV corticosteroids, and surgical co-review (original synthesis · not guideline verbatim).
- The four systemic markers (fever, tachycardia, anemia, elevated ESR) drive the severe classification when combined with frequent bloody stools.
- Failure of IV steroids by day 3 should trigger rescue therapy (infliximab or ciclosporin) or colectomy discussion.
References
- Truelove SC, Witts LJ. Cortisone in ulcerative colitis; final report. BMJ. 1955.
- Lamb CA, et al. British Society of Gastroenterology IBD guidelines. Gut. 2019.
Worked calculation
The values below come from this tool's own example placeholders and are computed server-side with the formula shown on this page, so the arithmetic can be checked quickly. It demonstrates how to substitute values only — it is not clinical advice and not a real case.
| Stools per day | <4 |
|---|---|
| Blood in stool | Present |
| Temperature >37.8°C | Yes |
| Heart rate >90 bpm | Yes |
| Hemoglobin <105 g/L | Yes |
| ESR >30 mm/h | Yes |
→UC severityModerate
- Systemic features：4 / 4 (fever/HR/anemia/ESR)
Frequently asked questions
- What is Truelove-Witts Ulcerative Colitis Severity?
- The Truelove and Witts criteria classify an acute ulcerative colitis flare as mild, moderate, or severe from bowel and systemic features.
- How is Truelove-Witts Ulcerative Colitis Severity calculated? What is the core formula?
- Severe = ≥6 bloody stools/day plus ≥1 of (temp >37.8°C, HR >90 bpm, Hb <105 g/L, ESR >30 mm/h). Mild = <4 stools/day with no systemic features. Otherwise moderate.
- When is Truelove-Witts Ulcerative Colitis Severity used?
- Select daily stool count, rectal bleeding, and four systemic markers; the tool returns the severity category and the number of systemic features present.
- What are the key clinical points for Truelove-Witts Ulcerative Colitis Severity?
- Acute severe UC meeting the criteria is a medical emergency requiring admission, IV corticosteroids, and surgical co-review (original synthesis · not guideline verbatim). The four systemic markers (fever, tachycardia, anemia, elevated ESR) drive the severe classification when combined with frequent bloody stools. Failure of IV steroids by day 3 should trigger rescue therapy (infliximab or ciclosporin) or colectomy discussion.
- What are the limits and cautions when using Truelove-Witts Ulcerative Colitis Severity?
- For licensed clinicians and clinical researchers. Interpret results with history, investigations and local protocols; not a diagnosis or prescription, and not a substitute for multidisciplinary decision-making or local guidelines.
- How is Truelove-Witts Ulcerative Colitis Severity calculated in practice? Can you show a worked example?
- Inputs: Stools per day <4, Blood in stool Present, Temperature >37.8°C Yes, Heart rate >90 bpm Yes, Hemoglobin <105 g/L Yes, ESR >30 mm/h Yes → Result: UC severity Moderate（Systemic features: 4 / 4 (fever/HR/anemia/ESR)）