The Simple Endoscopic Score for Crohn's Disease (SES-CD)

 

Bowel segments:

(1) ileum (not including ileocecal valve or ileocolonic anastomosis)

(2) right colon (ileocecal valve, cecum, ascending colon to hepatic flexure)

(3) transverse colon (from hepatic to splenic flexures)

(4) left colon (from splenic flexure to rectosigmoid junction)

(5) rectum (distal to rectosigmoid junction)

 

Parameters scored in each segment:

(1) size of ulcers

(2) extent of ulceration

(3) affected surface

(4) narrowing or stenosis

Parameter	Finding	Points
size of ulcers	none	0
	aphthous ulcers <= 0.5 cm)	1
	large ulcers (0.5 to 2.0 cm)	2
	very large ulcers (> 2.0 cm)	3
extent of ulceration	none	0
	< 10%	1
	10 - 30%	2
	> 30%	3
affected surface	none (all unaffected)	0
	< 50%	1
	50 - 75%	2
	> 75%	3
narrowing	none	0
	single site, can be passed	1
	multiple sites, can be passed	2
	>=1 sites cannot be passed	3

 

subscore for each segment =

= SUM(points for all 4 parameters)

 

total score for endoscopic exam =

= SUM(subscores for all segments examined)

 

subscore for each feature =

= SUM(points for all segments examined)

 

Interpretation:

• minimum segment subscore: 0

• maximum segment subscore: 12

• minimum score for feature: 0

• maximum score for feature other than narrowing: 15

• maximum score for narrowing: 11 (if a scope cannot be passed more proximal segments cannot be examined).

• minimum total score: 0

• maximum total score: 56 (because of limits from luminal narrowing)

• The higher the score the more severe the Crohn's disease.

 

Future enhancement to spreadsheet:

(1) ability to exclude a segment not examined

(2) adjust responses for when the endoscope cannot be passed (for example, if the scope cannot be passed beyond the rectum then more proximal segments cannot be scored)