Ulcerative colitis: assessment of disease activity based on contemporary scales

Ulcerative colitis is a disease which has been attracting a growing interest in society. The contemporary lifestyle and diet cause an increasing number of patients to complain of gastrointestinal problems. The incidence of ulcerative colitis has not increased over the last few years; however, new medicinal substances and treatment possibilities have still been occurring. In order to standardise the assessment of patients with ulcerative colitis a number of scales have been developed for the assessment of their clinical status as well as changes in the endoscopic picture and nutritional status. The first scale assessing the severity of ulcerative colitis episodes, which is still being used today, was developed in 1955 by Truelove and Witts while they were studying the influence of cortisone on the course of ulcerative colitis. Currently, new scales are still being developed which aim to facilitate and standardise therapeutic decisions of doctors taking care of patients with ulcerative colitis as far as possible. Due to the prevalence of the disease the patients do not always find themselves in referral centres, but also in smaller hospitals that do not specialise in ulcerative colitis therapy. From the point of view of a surgeon the most important issue is determining whether the patient requires surgery or whether pharmacotherapy alone is sufficient. A rapid course of the disease, a high severity of complaints and malnutrition often leading to cachexia precludes conservative treatment and requires more radical management of the disease and surgical intervention.