Sakita-Miwa Classification is a widely used endoscopic system for staging the healing process of peptic ulcers (gastric and duodenal). It categorizes ulcers into three main stages—Active, Healing, and Scarring—each with two sub-stages. 1. Active Stage (A)
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H2 (Healing 2):
The defect becomes much smaller. New regenerating epithelium covers most of the ulcer floor, though a small white coating may still be visible. Scarring Phase (S)
The Sakita-Miwa classification is a fundamental endoscopic tool used in gastroenterology to categorize the life cycle of a gastric ulcer. Established by Japanese researchers Sakita and Miwa, this system provides a standardized language for clinicians to describe whether an ulcer is in an active state, a healing state, or a scarring state. By breaking down the healing process into six distinct stages, it allows doctors to monitor patient progress, evaluate the effectiveness of treatments, and predict the risk of recurrence or complications. Structure of the Classification
SAKITA
For bedside recall, the mnemonic:
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