Sakitamiwa Classification Best -

The ulcer has disappeared, replaced by a red scar consisting of young, delicate tissue. S2 (Scarring 2/White Scar):

The following table summarizes the endoscopic appearance at each stage.

: 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)

The red scar fades and becomes white over time (white scar), indicating long-term, mature scarring. Clinical Applications and Importance sakitamiwa classification

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

The is a globally recognized endoscopic grading system used to evaluate the life cycle and healing stages of peptic (specifically gastric) ulcers. Developed in Japan, it provides clinicians with a standardized framework to assess whether an ulcer is in an active, healing, or scarring phase. This classification directly informs treatment efficacy and determines the duration of acid-suppressive therapy. 🔬 Classification Breakdown

The ulcer is deep, covered with a thick white or yellow coating (slough), and the surrounding tissue (gastric wall) is significantly swollen and reddened. A2 (Active 2): The ulcer has disappeared, replaced by a red

💡 Doctors use this system to determine if a treatment—like proton pump inhibitors (PPIs) —is working. An ulcer is medically considered "cured" once it reaches the S1 or S2 stage.

: The healing accelerates. The central white patch shrinks significantly, turning into a tiny island surrounded by a dominant, concentric ring of fresh red tissue. 3. The Scarring Stage (Stage S)

The is a globally recognized endoscopic staging system used in gastroenterology to assess the healing progression and chronological activity of peptic ulcers . Developed by Japanese researchers Sakita and Miwa, this classification system provides a highly structured framework that breaks down the lifecycle of gastric and duodenal mucosal lesions into three primary phases: Active (A), Healing (H), and Scarring (S) . Each of these phases is further bifurcated into two sub-stages (1 and 2), creating a comprehensive six-stage clinical scale that guides therapeutic interventions, tracks mucosal recovery, and standardizes scientific research. The ulcer grows noticeably shallower, and the surrounding

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The ulcer is very shallow and nearly covered by new tissue. The surrounding inflammation has largely disappeared. PubMed Central (PMC) (.gov) 3. Scarring Stage (S)

At this point, the ulcer is considered "endoscopically cured" because the mucosal defect has vanished.

The ulcer base is completely covered by new epithelium, but the area remains red and vascularized. This is a "fresh" scar.