grading colitis

 Is colitis clasified mild,mod.,severe by symptoms or through colonoscopy biopsy?

My report after sig-scope stated moderate colitis,not once did the g.i ask what my symptoms are ,on some web-sites it states mild-less then 4 stools a day etc. which determines if you are mild or severe ? Thank you

My GI always says mine is pretty mild by the look of the tissue but my symptoms seem severe.

There is also a score that is given. I have seen this is clinical trials:
http://ibdcrohns.about.com/od/Glossary/g/Ulcerative-Colitis-Disease-Activity-Index-Ucdai.htm

I asked my GI what my score was and she said it was low. I was in remission at the time so I don't see how accurate it can be as to the severity of my active disease.

I've been curious about this too. I wanted to know at what point I consider myself in remission.

Anyway, I know some people mention they are flaring when they have 1 or 2 bouts of D in a week, and they increase the 5ASA for a while and things calm back down. The only time I've had any semblance of a normal BM was when I was on 30-40mg prednisone. But that can't really be considered remission since the UC is still completely active, the prednisone is just covering the symptoms right?

It just seems like everyone has very different definitions of remission/flare.

     My colitis was always located in the rectum.  My last colonoscopy it was rated as moderate, but I was as sick as a dog...bleeding, urgency..ugh, just awful.

Great question!   I think an important point is that as patients we mean US and all the negative stuff that goes with it. We mean mild/moderate/severe in terms of our total subjective and objective lived experience, which might include rawness/hemorrhoids secondary to diarrhea, dehydration symptoms, anemia secondary to bleeding, stress related to managing UC, IBS concomitant to UC, major social/family disruptions ... etc.   Medical research is defining mild/moderate/severe in terms of how deformed the mucosal lining is . They may also use a scale of symptoms that count bowel movements, presence of pain, presence of blood - but these are very messy because you generally report your stool quality (rather than turn it in) . One person's splash of blood is another's regular bleeding, or one person will say 5 BM, while another would say 2 BM and 3 more times with only mucus. (There was an interesting thread here a few months back on "what counts" when the doc asks how many BM).   I think the medical practitioner has to be somewhere in the middle, balancing strict UC histology results against patient quality of life. Then there are insurance companies, where some treatments may not be covered unless you have a diagnosis of "moderate" or "severe".   Here is an interesting link to articles on this topic: http://scholar.google.com/scholar?q=assessment+of+disease+activity+in+ulcerative+colitis&hl=en&as_sdt=0&as_vis=1&oi=scholart   I was interested to read about "faecal calprotectin" tests that might reduce then need for so many colonoscopies.: http://en.wikipedia.org/wiki/Faecal_calprotectin  - also is distinguishes IBD form IBS.