Classification of ulcerative colitis

The severity of ulcerative colitis is determined by certain criteria. Ulcerative colitis can be classified as mild, moderate, or severe, which may guide treatment choices.1

People who have mild ulcerative colitis may have:

  • Fewer than four stools per day.
  • No bleeding or a small amount of bleeding with stools.
  • Normal or mild elevation of erythrocyte sedimentation rate (ESR).

People who have mild ulcerative colitis do not have fever, rapid heartbeat, or anemia.

People who have moderate ulcerative colitis have:

  • More than four stools per day.
  • Cramping abdominal pain and an urgent need to have a bowel movement.
  • Mild elevation in erythrocyte sedimentation rate.

People who have severe ulcerative colitis usually:

  • Have more than six stools per day (constant loose stools).
  • Have frequent bleeding from the rectum.
  • Have fever, rapid heartbeat, and anemia.
  • Have an elevated erythrocyte sedimentation rate.
  • Feel very ill.

Flare-ups can be so severe that they require hospitalization.


  1. Kornbluth A, Sachar DB (2004). Ulcerative colitis practice guidelines in adults (update): American College of Gastroenterology, Practice Parameters Committee. American Journal of Gastroenterology, 99(7): 1371–1385.

Last Updated: November 3, 2008

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