Paris classification of ulcerative colitis in children

	Categories used in Montreal classification (adults)	Modified categories used in Paris classification (children and adolescents)	Definition
Age at diagnosis	A1	A1a	0 to <10 years
	A1	A1b	10 to <17 years
	A2		17 to 40 years
	A3		>40 years
Location	E1		Ulcerative proctitis
	E2		Left-sided ulcerative colitis (extending distal to the splenic flexure)
	E3	E3	Extensive (extending distally from the hepatic flexure)
	E3	E4	Pancolitis (including areas proximal to the hepatic flexure)
Severity		S0	Never severe*
Severity		S1	Ever severe*
Growth		G₀	No growth delay
Growth		G₁	Growth delay (impaired linear growth)^¶

The Paris classification of inflammatory bowel disease in children is a modification of the Montreal classification used for adults. This classification incorporates age categories within the pediatric range and includes categories for growth effects. Disease extent is defined using macroscopic appearance rather than evidence from histology or radiology.

* "Severe" is defined by a Pediatric Ulcerative Colitis Activity Index (PUCAI) ≥65.
¶ Impaired linear growth is manifested by either height Z-score at diagnosis that is significantly less than expected, or a significant reduction in height Z-score since diagnosis.

Modified with permission from: Levine A, Griffiths A, Markowitz J, et al. Pediatric modification of the Montreal classification for inflammatory bowel disease: The Paris classification. Inflamm Bowel Dis 2011; 17:1314. DOI: 10.1002/ibd.21493. Copyright © 2011 Crohn's and Colitis Foundation of America, Inc. Unauthorized reproduction of this material is prohibited.

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Paris classification of ulcerative colitis in children