Calculators & Tools

PUCAI — Paediatric Ulcerative Colitis Activity Index

Disease activity in paediatric ulcerative colitis; guides escalation in acute severe colitis.

1 What is the PUCAI — Paediatric Ulcerative Colitis Activity Index?

The PUCAI — Paediatric Ulcerative Colitis Activity Index is a GI & Liver scoring tool used in paediatric practice. Disease activity in paediatric ulcerative colitis; guides escalation in acute severe colitis. It scores 6 criteria and interprets the total across 4 bands, so the number always arrives with the severity it implies rather than on its own. In PediAid each criterion is shown as a labelled option with the weight it carries, so the total can be checked rather than taken on trust.

2 When to use it

  • Grading severity at the bedside in GI & Liver
  • Recording an objective severity band in the case notes
  • Deciding when a total crosses the threshold for escalation
  • Re-scoring to track whether a child is improving or deteriorating
  • Checking the exact criteria of a score used infrequently

3 Formula & method

The score sums 6 criteria: Abdominal pain; Rectal bleeding; Stool consistency of most stools; Number of stools per 24 hours; Nocturnal stools (any episode causing waking); Activity level. Totals are then banded: any score - Remission: pUCAI <10 - clinical remission; 10 points or more - Mild: pUCAI 10-34 - mild disease; 35 points or more - Moderate: pUCAI 35-64 - moderate disease. Optimise therapy and arrange close review; 65 points or more - Severe: pUCAI ≥65 - severe (acute severe colitis). Admit for IV corticosteroids; PUCAI >45 on day 3 and >65 on day 5 predicts steroid failure and should trigger second-line therapy planning.
  • Total range 0-85.
  • Source: Turner D et al. Development, validation and evaluation of a paediatric ulcerative colitis activity index. Gastroenterology 2007;133:423-32.

4 Frequently asked questions

How many criteria does the PUCAI — Paediatric Ulcerative Colitis Activity Index use?

6. They are Abdominal pain; Rectal bleeding; Stool consistency of most stools; Number of stools per 24 hours; Nocturnal stools (any episode causing waking); Activity level.

What do the bands of the PUCAI — Paediatric Ulcerative Colitis Activity Index mean?

The total is interpreted as: any score - Remission: pUCAI <10 - clinical remission; 10 points or more - Mild: pUCAI 10-34 - mild disease; 35 points or more - Moderate: pUCAI 35-64 - moderate disease. Optimise therapy and arrange close review; 65 points or more - Severe: pUCAI ≥65 - severe (acute severe colitis). Admit for IV corticosteroids; PUCAI >45 on day 3 and >65 on day 5 predicts steroid failure and should trigger second-line therapy planning.

Does the score replace clinical judgement?

No. It is a structured way to record and communicate severity. A clinician concerned about a child should act on that concern regardless of the total.

Where does this score come from?

Total range 0-85.

Does it work offline?

Yes. Score definitions are bundled with the PediAid app, so the score computes without a connection.

For qualified clinicians. This page and the PediAid app are a clinical aid only. Calculations and reference data must be verified against the patient's clinical context, the source guideline and your local protocols before any treatment decision is made.