Simplified Endoscopic Activity Score for Crohn’s Disease (SES-CD)
Calculates SES-CD based on endoscopic findings in 5 bowel segments.
Scoring Table
| Segment | Ulcer size | Ulcerated surface | Affected surface | Narrowing |
|---|
Each item is scored 0 to 3 per segment. Total SES-CD = sum of all item scores across all 5 segments.
Result
SES-CD Item Definitions
Ulcer size
- 0 = None
- 1 = Aphthous ulcers, diameter 0.1 to 0.5 cm
- 2 = Large ulcers, diameter 0.5 to 2 cm
- 3 = Very large ulcers, diameter > 2 cm
Ulcerated surface
- 0 = None
- 1 = < 10%
- 2 = 10% to 30%
- 3 = > 30%
Affected surface
- 0 = Unaffected
- 1 = < 50%
- 2 = 50% to 75%
- 3 = > 75%
Narrowing
- 0 = None
- 1 = Single, can be passed
- 2 = Multiple, can be passed
- 3 = Cannot be passed
The Simplified Endoscopic Activity Score for Crohn’s Disease (SES-CD) is a standard endoscopic scoring system used to measure how severe Crohn’s disease looks during ileocolonoscopy. It was developed as a simpler alternative to the older CDEIS score and is used in research and clinical practice to describe mucosal disease activity and track response to treatment.
SES-CD scores 5 bowel segments:
- ileum
- right colon
- transverse colon
- left colon/sigmoid
- rectum
In each segment, it rates 4 endoscopic features, each from 0 to 3:
- ulcer size
- ulcerated surface
- affected surface
- narrowing/stenosis
The total SES-CD is the sum of all those scores. That gives a possible range of 0 to 60, with higher scores meaning more severe endoscopic Crohn’s activity.
A common simplified way to think about it is:
- 0 = no visible endoscopic activity
- higher numbers = more extensive ulcers, more inflamed/affected surface, and/or more significant narrowing
One important detail: the score itself is standardized, but the exact cutoffs for “mild,” “moderate,” “severe,” or “endoscopic remission” can vary by study or clinical context. For example, some recent work uses SES-CD < 4 as a remission-type threshold in certain settings.
