__exclusive__ - Sakitamiwa Classification

| Phase | Stage | Description of Endoscopic Findings | | :--- | :--- | :--- | | | A1 | The surrounding mucosa is edematously swollen . There is no visible regenerating epithelium. A thick white slough or fibrin layer covers the ulcer base. | | | A2 | The surrounding edema has decreased , making the ulcer margin clearer. A slight amount of regenerating epithelium is visible at the ulcer margin. A red halo and a white slough around the ulcer margin are frequently seen. | | Healing | H1 | The white coating on the ulcer base is becoming thinner . The regenerating epithelium is visibly extending into the ulcer base. The ulcer crater is still evident, but the gradient between the margin and the floor is becoming flat. The mucosal defect is approximately 50-66% of its size at stage A1. | | | H2 | The mucosal defect is smaller than in H1. The regenerating epithelium now covers most of the ulcer floor . The area of white coating is about 25-33% of its size at stage A1. | | Scarring | S1 | The regenerating epithelium has completely covered the ulcer floor, and the white coating has disappeared. The new epithelium is markedly red due to its rich capillary network. This is known as a "red scar." | | | S2 | The redness of the scar has gradually faded over several months to a few years, and the area now closely matches the color of the surrounding mucosa . This is known as a "white scar." |

The Sakita-Miwa classification is not just for tracking; it helps dictate treatment effectiveness. sakitamiwa classification

For more specific information on how healing stages are assessed, studies like this randomized trial are useful, say researchers in Gut and Liver (2026). | Phase | Stage | Description of Endoscopic

It appears to be either:

To facilitate clinical trials and precise quantitative studies, the Sakita-Miwa stages can be translated into numerical scores, allowing clinicians to track healing statistically. Description Healing Score A1cap A sub 1 Active Stage 1 5 (Most Active) A2cap A sub 2 Active Stage 2 H1cap H sub 1 Healing Stage 1 H2cap H sub 2 Healing Stage 2 S1cap S sub 1 S2cap S sub 2 White Scar 0 (Healed) | | | A2 | The surrounding edema

Over weeks or months, the redness fades into a white or pale scar as the tissue matures. This marks the final stage of healing. Clinical Utility and Scoring

The classification divides the natural history of a peptic ulcer into three distinct chronological phases: . These three phases are then further broken down into two stages each, creating a six-stage system: A1, A2, H1, H2, S1, and S2.