|work| | Sakitamiwa Classification

: Swelling decreases, and the ulcer margin becomes clear. A small amount of regenerating epithelium may appear at the edges, often accompanied by a red "halo" or white "circle" around the margin. Healing Stage (H)

The active phase marks the acute stage of the ulcer, where the lesion is at its most aggressive state.

This stage represents the initial, acute phase of the ulcer where the mucosal defect is most prominent.

The is the global clinical standard for staging gastric and peptic ulcers. Developed in 1971 by Japanese gastroenterologists Sakita and Miwa, this six-stage endoscopic framework organizes the life cycle of an ulcer into three overarching macro-stages: Active (A) , Healing (H) , and Scarring (S) . sakitamiwa classification

Primarily used in Western practice, the Forrest system is geared toward assessing the risk of re-bleeding from an ulcer (e.g., active bleeding vs. clean base), rather than the healing stage.

: The white exudate has completely disappeared. The ulcer is replaced by a flat, red, regenerating mucosal scar, often radiating outward in a star-like pattern.

The is the globally recognized endoscopic staging system used by gastroenterologists to evaluate the lifecycle and healing progression of peptic ulcers . First proposed by Japanese researchers Sakita and Miwa in 1971, this classification system translates the complex, continuous biological process of mucosal wound healing into structured categorical data. : Swelling decreases, and the ulcer margin becomes clear

: The redness fades, and the area becomes a white scar as the mucosa fully matures. Clinical Importance Healing Assessment

It helps detect endoscopic findings like compound ulcers or those associated with other conditions, such as superior mesenteric artery syndrome.

: The slough has nearly vanished, leaving only a tiny central island of white coating. The ulcer grows noticeably shallower, and the surrounding mucosa starts organizing into a converging, radial pattern of mucosal folds moving toward the healing center. 3. The Scarring Stage (S) This stage represents the initial, acute phase of

The (frequently searched as "sakitamiwa") is a critically acclaimed six-stage endoscopic grading system used primarily in East Asian clinical practice to evaluate, track, and stage the healing process of gastric and peptic ulcers. While Western gastroenterologists often rely on systems like the Forrest classification to assess active bleeding and rebleeding risks, the Sakita-Miwa system serves as the gold standard for tracking chronological tissue repair, from acute breakdown to complete mucosal scarring.

: The ulcer crater is mostly gone, leaving behind a highly superficial mucosal defect. The white slough layer is reduced to a minimal speck or has vanished entirely. Regenerating tissue prominently covers the vast majority of the previous wound site. 3. The Scarring Stage (S)

The edema begins to subside. While the white coating remains, the margins become more distinct, and the surrounding mucosa may show early signs of regeneration. 2. The Healing Stage (H) H1 (Healing-1):

By identifying the stage (A, H, or S), clinicians can determine if a peptic ulcer is responding to medication within the typical 3-4 week expected healing time.