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PUCAI Calculator

The ulcerative colitis score children’s inflammatory bowel disease (IBD) teams use, made from six things a parent or young person can report.

The Paediatric Ulcerative Colitis Activity Index (PUCAI) describes how active ulcerative colitis is in a child or teenager. It was published in 2007, scores from 0 to 85, and is used by children’s IBD teams and in the rules for some funded medicines in Australia and New Zealand.

All six items are things a parent or the young person can report: tummy pain, bleeding, what the stools are like, how many there are, whether any wake your child at night, and how much activity is limited. It needs no blood test or examination.

Work out your PUCAI score

Abdominal (tummy) pain
Rectal bleeding (blood from the bottom)
What most stools (poos) are like
Number of stools in 24 hours
Stools at night (any that wake your child)
How much your child’s activity is limited

How the PUCAI score is used where you live

Australia

In Australia, many medicines are subsidised through the Pharmaceutical Benefits Scheme (PBS). For some subsidised ulcerative colitis medicines for children and teenagers, the PBS uses a PUCAI score of at least 30 to start treatment, and a score under 10 to continue it. Sources: Services Australia: paediatric ulcerative colitis authority form (PB215); PBS: ulcerative colitis, continuing treatment (item 10960W).

Canada

In Canada, provincial drug plans and private insurers set their own rules for some ulcerative colitis medicines, and some of them ask your child’s specialist for a disease activity score. Your child’s IBD team may use the PUCAI to track how active ulcerative colitis is.

New Zealand

In New Zealand, Pharmac, the government agency that decides which medicines are funded, asks for a Special Authority form for some of them. One of Pharmac’s Special Authority forms, for example, uses a PUCAI of 20 or more to start treatment, and a fall of 10 points or more to continue it. Source: Pharmac: Special Authority form SA2183.

United Kingdom

Your child’s IBD team may use the PUCAI to track how active ulcerative colitis is. Medicines funding rules that ask for a score say which one they need.

United States

In the US, health insurers set their own rules for approving some ulcerative colitis medicines, and some ask your child’s doctor for a disease activity score. Your child’s IBD team may use the PUCAI to track how active ulcerative colitis is.

Somewhere else

Your child’s IBD team may use the PUCAI to track how active ulcerative colitis is. Medicines funding rules that ask for a score say which one they need.

What the total means

The PUCAI score describes how active ulcerative colitis looks from the answers given. If your IBD team asks you to answer for a set number of days, use those days. It doesn’t diagnose anything, and your IBD team reads it alongside everything else they know about you.

  • Under 10: the range the index’s authors call remission
  • 10 to 34: the range they call mild
  • 35 to 64: the range they call moderate
  • 65 or more: the range they call severe

Sources