MDCalc

Simplified Endoscopic Activity Score for Crohn’s Disease (SES-CD)

Assesses severity of Crohn disease based on endoscopic findings.

Ileum

The segment has been

Size of ulcers

Ulcerated surface

Affected surface

Presence of narrowings

Right Colon

Includes the ileocecal valve and cecum

The segment has been

Includes the ileocecal valve and cecum

Size of ulcers

Ulcerated surface

Affected surface

Presence of narrowings

Transverse Colon

The segment has been

Size of ulcers

Ulcerated surface

Affected surface

Presence of narrowings

Left Colon

The segment has been

Includes the sigmoid colon to the rectosigmoid junction

Size of ulcers

Ulcerated surface

Affected surface

Presence of narrowings

Rectum

The segment has been

Size of ulcers

Ulcerated surface

Affected surface

Presence of narrowings

Result:

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Advice
  • This tool should not drive therapy decisions in isolation; interpret results alongside the full clinical picture (e.g., symptoms, biomarkers, and specialist expertise) to guide management and decisions about follow-up endoscopic reassessment.
  • Severity cutoffs are not universally standardized; avoid overinterpreting severity categories and focus on baseline-to-follow-up change.
  • Many define endoscopic response as a score reduction of ≥50% from baseline; some define endoscopic healing as a score <3.
Management
  • Currently, there are no universal management recommendations based on this score.
  • If results are meeting a chosen target:
    • Continuation of current therapy may be appropriate.
    • Deescalation can be considered cautiously and in context.
  • Partial response may necessitate:
    • Optimization of the medication regimen (e.g., dose or interval adjustments).
    • Assessing adherence.
  • High or worsening scores may require:
    • Escalation or change in therapy.
    • Evaluation for drivers of nonresponse (eg., infection, medication interference).
    • Additional evaluation for complications (e.g., imaging).