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The Truelove & Witts' Severity Assessment is a clinical tool used to categorize the severity of ulcerative colitis, a type of inflammatory bowel disease. This assessment is based on specific criteria including the number of bowel movements per day, presence and amount of blood in stools, body temperature (pyrexia), heart rate (pulse rate), presence of anaemia, and the erythrocyte sedimentation rate (ESR).
The assessment categorizes the condition into three levels of severity
| Criteria | Mild | Moderate | Severe |
|---|---|---|---|
| Bowel Movements (Number per Day) | Fewer than 4 | 4–6 | 6 or more plus at least one feature of systemic upset* |
| Blood in Stools | No more than small amounts of blood | Between mild and severe | Visible blood |
| Pyrexia (Temperature > 37.8°C) * | No | No | Yes |
| Pulse Rate (> 90 beats per minute) * | No | No | Yes |
| Anaemia * | No | No | Yes |
| Erythrocyte Sedimentation Rate (mm/hour) * | 30 or below | 30 or below | Above 30 |
| Situation | Action | Rationale |
|---|---|---|
| Emergency Hospital Admission Indicated | • Severe, nocturnal, or bloody diarrhoea (>6–8 stools/day). • Fever, dehydration, tachycardia, or hypotension. • Severe abdominal pain or suspected intestinal obstruction. • Signs of malnutrition (BMI < 18.5 kg/m²) or... |
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