Multiple Rectal Ulcers (68 of 110)

The clinical severity of ulcerative colitis depends on both the length of colon involved and the severity of colonic inflammation. The symptomatic criteria most commonly used to define the severity of disease were established by Truelove and Witts to assess improvement in the first clinical trial of cortisone for ulcerative colitis and remain useful to classify severity in clinical practice. The criteria define mild and severe disease activity with moderate activity being present when there are intermediate symptoms. These criteria may also be modified to include fulminant colitis. Most patients present with moderately severe symptoms of ulcerative colitis and the course is, typically, intermittent with the majority of patients maintained in clinical remission or having mild symptoms despite a 90% likelihood of relapse if medical therapy is not maintained.