Table 2: SOMA-LENT Scale [922].

Grade 1Grade 2Grade 3Grade 4Score

Subjective
 TenesmusOccasional urgencyFrequent urgencyConstant urgencyNonresponder
 Mucus lostOccasionalFrequentConstantNonresponder
 IncontinenceOccasionalFrequentConstantNonresponder
 Defecation frequency2–4 times/day4–8 times/day>8 times/day Incontrol diarrhea
 PainOccasional and minimal Frequent and tolerableConstant and intenseNonresponder and atrocious
Objective
 BleedingHideOccasional >2/weekConstant/dailyBrutal bleeding
 UlcerationSuperficial ≤1 cm²Superficial >1 cm²Deep ulcerPerforation. Fistula
 Stenosis >2/3 normal diameter without dilation1/3 à 2/3 normal diameter with dilation<1/3 normal diameterComplete stenosis
Management
 Tenesmus and
 defecation frequency
Occasional ≤2 antidiarrhea medication/weekUsually >2 antidiarrhea medication/weekSeveral >2 antidiarrhea medication/daySurgery/colostomy
 PainOccasional, nonopiate treatmentUsually nonopiate treatmentUsually with opiate treatmentSurgery
 BleedingLaxatives, for treatmentOccasional blood transfusionFrequent blood transfusionSurgery/colostomy
 UlcerationDietary management, laxativesOccasional corticosteroidsSteroids rectal injection, HBOTSurgery/colostomy
 StenosisDietary managementOccasional dilationUsually dilationSurgery
 IncontinenceOccasional use of protective padsFrequent use of protective padsConstant use of protective padsSurgery/colostomy