UCEIS Score • UC Severity Index
Apply the endoscopic findings for vascular pattern, bleeding, and ulceration to visualize the UCEIS severity staging.
Guidelines & Evidence
Verified
Last Review: 2026-07-17
When to Use
When to Use
Endoscopic quantification of inflammatory activity in Ulcerative Colitis (UC)
Standardized monitoring of mucosal healing in clinical practice and trials
To provide a more granular assessment than the Mayo Endoscopic Subscore (MES)
UCEIS vs. Mayo
The UCEIS (2012) was developed to provide a strictly defined, validated endoscopic scale. Unlike the Mayo score, it separates "Vascular Pattern" from "Bleeding" and "Ulceration," reducing observer subjectivity.
How it Works
The 3 Domains (Sum 0–8 pts)
01
Vascular Pattern (0–2): Normal (0), Patchy obliteration (1), or Complete obliteration (2).
02
Bleeding (0–3): None (0), Mucosal (1), Luminal mild (2), or Luminal frank (3).
03
Erosions & Ulcers (0–3): None (0), Erosions (1), Superficial ulcer (2), or Deep ulcer (3).
Severity Definition
| 0–1 Points | Remission / Normal |
| 2–4 Points | Mild Activity |
| 5–6 Points | Moderate Activity |
| 7–8 Points | Severe Activity |
Clinical Pearls
Predicting Steroid Resistance
In patients with Acute Severe UC, a UCEIS score of ≥ 7 on admission is a powerful predictor of corticosteroid failure and the need for rescue therapy or surgery.
The "Frank Bleeding" Sign
Frank luminal bleeding (UCEIS Grade 3 in the bleeding domain) indicates deep capillary exposure and is the endoscopic hallmark of severe necrotizing mucosal injury.
Clinical Pearls
The score is calculated for the MOST SEVERELY AFFECTED area visualized during the procedure
Vascular pattern obliteration reflects the interstitial oedema that physically compresses capillary visibility
UCEIS has better inter-observer agreement among general endoscopists compared to the Mayo score
The Evidence
The Defining System
Developing a prospective, multicenter, randomized, double-blind study of a new endoscopic index of severity for ulcerative colitis: the UCEIS.
Travis SP et al. • Gut. 2012;61(4):535-42. The seminal validation of the UCEIS instrument.
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Origins & History
Simon Travis & International Experts
Developed by a global group of experts led by the Oxford IBD unit. They aimed to create a tool that eliminated the ambiguity of terms like "friability" (found in the Mayo score), which are difficult to standardize across different centers and cultures.
Last Comprehensive Review: 2026-07-17