What is a normal SCCAI score?

A score of 2 or less is in the range patients described as remission in a validation study. A score of 5 or more is the line one study used to define a relapse.

What SCCAI score means remission?

Under 2.5, which in whole points means 2 or less. That cut-off came from 66 people with ulcerative colitis who reported whether they themselves felt in remission.

What SCCAI score means a flare?

A score of 5 or more defined relapse in a 2003 study, with 92% sensitivity and 93% specificity against clinicians' judgement. It is a guide, not a diagnosis, so a rising score is a reason to contact your IBD team rather than proof of a flare.

How much does the SCCAI need to change to matter?

A fall of more than 1.5 points, so 2 or more in whole points, matched a clinically meaningful improvement in validation work. Smaller moves are within the noise of day-to-day symptoms.

Can I score the SCCAI myself?

Yes. Unlike the full Mayo score, it needs no examination or tests. When patients and gastroenterologists scored it on the same day, they agreed on active disease versus remission in 87% of cases.

What is the difference between the SCCAI and the PRO-2 score?

PRO-2 uses only stool frequency and rectal bleeding from the Mayo score and runs from 0 to 6. The SCCAI adds night-time stools, urgency, general well-being and four extraintestinal features, and runs from 0 to 19.

What is the maximum SCCAI score?

The maximum is 19: 3 for daytime frequency, 2 for night-time frequency, 3 for urgency, 3 for blood, 4 for well-being and 4 for extraintestinal features.

Does a low SCCAI mean my colon has healed?

No. In a colonoscopy study the index missed more than half of the people with endoscopically active disease. A low score is reassuring about symptoms, and healing is checked with calprotectin or a scope.

SCCAI Calculator for Ulcerative Colitis

Score your ulcerative colitis symptoms with the Simple Clinical Colitis Activity Index.

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About 2 minutes
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Updated October 3, 2026

The short answer

The Simple Clinical Colitis Activity Index (SCCAI) scores ulcerative colitis symptoms from 0 to 19 across six items: daytime bowel frequency (0 to 3), night-time bowel frequency (0 to 2), urgency (0 to 3), blood in the stool (0 to 3), general well-being (0 to 4) and 1 point each for arthritis, uveitis, erythema nodosum and pyoderma gangrenosum. A score of 2 or less matches patient-defined remission, a score of 5 or more is the line one study used to define relapse, and a fall of 2 or more points is a meaningful improvement.

How many times a day are you opening your bowels during the daytime?Think about a typical day recently. Count every time you pass stool, whatever it looks like.

How many times a night are you getting up to open your bowels?Only count times you get up to open your bowels, not waking for other reasons.

How urgent is the need to go?

How much blood is there in your stool?

How is your general well-being?

Do you currently have any of these?Tick only those that are present now. Each scores 1 point. Eye and skin conditions should have been confirmed by a doctor.

Arthritis (painful, swollen joints)Uveitis (painful red eye, blurred vision, diagnosed by a doctor)Erythema nodosum (tender red lumps, usually on the shins)Pyoderma gangrenosum (a deep, painful skin ulcer)

Your previous SCCAI score, if you know itOptional. Used to show how much your score has changed.

How to use the SCCAI Calculator

1Choose how often you open your bowels by day and by night, using a typical recent day.
2Rate your urgency, the amount of blood in your stool and your general well-being.
3Tick any of the four extraintestinal features you currently have.
4Get your total out of 19, where it sits against the remission and relapse lines, and, if you add a previous score, how much it has changed.

How the SCCAI is scored

Richard Walmsley and colleagues published the index in 1998 as a quick way to judge an ulcerative colitis flare without blood tests or an endoscopy. In its development it correlated very closely with the more complex Powell-Tuck index, which includes a sigmoidoscopy (r = 0.959), and with laboratory markers of severity. A later prospective comparison of the non-invasive indices then available found it among the two best performers for validity, reliability and responsiveness.

The items are added with no weighting, giving a total from 0 to 19. Daytime and night-time stools are scored separately, and urgency has its own item, which the shorter PRO-2 score leaves out.

Item	How it is scored	Points
Bowel frequency, day	0 to 3 times 0, 4 to 6 times 1, 7 to 9 times 2, more than 9 times 3	0 to 3
Bowel frequency, night	None 0, 1 to 3 times 1, 4 to 6 times 2	0 to 2
Urgency	None 0, hurry 1, immediately (toilet nearby) 2, incontinence 3	0 to 3
Blood in stool	None 0, trace 1, occasionally frank (under 50% of stools) 2, usually frank (over 50%) 3	0 to 3
General well-being	Very well 0, slightly below par 1, poor 2, very poor 3, terrible 4	0 to 4
Extraintestinal features	1 each: arthritis, uveitis, erythema nodosum, pyoderma gangrenosum	0 to 4

What your score means

The original paper did not set severity bands. The two lines that have been tested come from later studies. In 66 people with ulcerative colitis who said whether they felt in remission, a score under 2.5 matched patient-defined remission and a fall of more than 1.5 points matched a clinically meaningful improvement. In a separate study of 71 clinic visits, a score of 5 or more identified relapse with 92% sensitivity and 93% specificity against the clinician's judgement.

We do not use mild, moderate or severe labels because we could not find a validated source for them. Scores of 3 and 4 sit between the two tested lines, and the item breakdown is what tells you whether a 4 is mostly blood or mostly how you feel. Our guide to knowing whether your ulcerative colitis is flaring works through examples.

Score	What it lines up with	Source
0 to 2	Patient-defined remission (under 2.5)	Higgins 2005
3 to 4	Above remission, below the relapse line	Between the two tested cut-offs
5 or more	The score used to define relapse	Jowett 2003
A fall of 2 or more	Clinically meaningful improvement (more than 1.5)	Higgins 2005

What the score cannot tell you

It measures symptoms, not the lining of your colon. In a prospective study of people having a colonoscopy, the SCCAI picked up endoscopically active disease with only 43% sensitivity but 96% specificity: a high score almost always means something is happening, while a low score does not prove the colon is quiet.

Symptoms of ulcerative colitis can also come from other things, such as an infection, a medicine side effect or an overlap with IBS-type symptoms in remission. If your score and how you feel do not match, a calprotectin test is often the next step your team will suggest. For a two-item score that matches how trials report results, use the PRO-2 calculator.

Frequently asked questions

What is a normal SCCAI score?: A score of 2 or less is in the range patients described as remission in a validation study. A score of 5 or more is the line one study used to define a relapse.
What SCCAI score means remission?: Under 2.5, which in whole points means 2 or less. That cut-off came from 66 people with ulcerative colitis who reported whether they themselves felt in remission.
What SCCAI score means a flare?: A score of 5 or more defined relapse in a 2003 study, with 92% sensitivity and 93% specificity against clinicians' judgement. It is a guide, not a diagnosis, so a rising score is a reason to contact your IBD team rather than proof of a flare.
How much does the SCCAI need to change to matter?: A fall of more than 1.5 points, so 2 or more in whole points, matched a clinically meaningful improvement in validation work. Smaller moves are within the noise of day-to-day symptoms.
Can I score the SCCAI myself?: Yes. Unlike the full Mayo score, it needs no examination or tests. When patients and gastroenterologists scored it on the same day, they agreed on active disease versus remission in 87% of cases.
What is the difference between the SCCAI and the PRO-2 score?: PRO-2 uses only stool frequency and rectal bleeding from the Mayo score and runs from 0 to 6. The SCCAI adds night-time stools, urgency, general well-being and four extraintestinal features, and runs from 0 to 19.
What is the maximum SCCAI score?: The maximum is 19: 3 for daytime frequency, 2 for night-time frequency, 3 for urgency, 3 for blood, 4 for well-being and 4 for extraintestinal features.
Does a low SCCAI mean my colon has healed?: No. In a colonoscopy study the index missed more than half of the people with endoscopically active disease. A low score is reassuring about symptoms, and healing is checked with calprotectin or a scope.

How to Know If Your Ulcerative Colitis Is Flaring
A flare means active inflammation, not just a bad week. How to compare today with your own baseline, score yourself, and know when a test is needed.
PRO-2 Score in Ulcerative Colitis: What It Means
PRO-2 is two Mayo score items, stool frequency and rectal bleeding, each 0-3, totalling 0-6. What the number means, what it misses, and how to read it.
What to Track in an IBD Symptom Diary
An IBD diary needs three layers: a daily symptom log, a dated event log for doses and steroids, and a treatment record that follows you. What goes in each.
How to Stop Urgency With Ulcerative Colitis
Bowel urgency in UC comes from a stiff, hypersensitive rectum, not weak willpower. What reduces it, why it lags behind healing, and what to ask for next.
When to Go to the Hospital for a UC Flare
Six or more bloody stools a day plus a fever, a fast pulse or feeling systemically unwell is the threshold that makes a UC flare a hospital problem.

Sources

Walmsley RS, Ayres RC, Pounder RE, Allan RN. A simple clinical colitis activity index. Gut. 1998;43(1):29-32. doi:10.1136/gut.43.1.29
Walsh A, Cao R, Wong D, Kantschuster R, Matini L, Wilson J, et al. Using item response theory (IRT) to improve the efficiency of the Simple Clinical Colitis Activity Index (SCCAI) for patients with ulcerative colitis. BMC Gastroenterol. 2021;21(1):132. doi:10.1186/s12876-021-01621-y
Higgins PDR, Schwartz M, Mapili J, Krokos I, Leung J, Zimmermann EM. Patient defined dichotomous end points for remission and clinical improvement in ulcerative colitis. Gut. 2005;54(6):782-8. doi:10.1136/gut.2004.056358
Jowett SL, Seal CJ, Phillips E, Gregory W, Barton JR, Welfare MR. Defining relapse of ulcerative colitis using a symptom-based activity index. Scand J Gastroenterol. 2003;38(2):164-71. doi:10.1080/00365520310000654
Bennebroek Evertsz' F, Nieuwkerk PT, Stokkers PCF, Ponsioen CY, Bockting CLH, Sanderman R, et al. The Patient Simple Clinical Colitis Activity Index (P-SCCAI) can detect ulcerative colitis (UC) disease activity in remission: a comparison of the P-SCCAI with clinician-based SCCAI and biological markers. J Crohns Colitis. 2013;7(11):890-900. doi:10.1016/j.crohns.2012.11.007
Turner D, Seow CH, Greenberg GR, Griffiths AM, Silverberg MS, Steinhart AH. A systematic prospective comparison of noninvasive disease activity indices in ulcerative colitis. Clin Gastroenterol Hepatol. 2009;7(10):1081-8. doi:10.1016/j.cgh.2009.06.024
Falvey JD, Hoskin T, Meijer B, Ashcroft A, Walmsley R, Day AS, et al. Disease activity assessment in IBD: clinical indices and biomarkers fail to predict endoscopic remission. Inflamm Bowel Dis. 2015;21(4):824-31. doi:10.1097/MIB.0000000000000341

Cite this tool

Clairop. SCCAI Calculator. www.clairop.com/tools/sccai-calculator. Updated October 3, 2026.

Clairop is a general wellness app for people living with a diagnosed digestive condition. It does not replace professional medical care, diagnosis, or treatment. Always follow your healthcare provider's advice.

Clairop logs meals, symptoms and stool in seconds, then looks for the foods your gut reacts to, including reactions that land days later.

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