Sakitamiwa Classification | 2025 |

Over time, the red scar matures and turns white, indicating the final stage of complete healing. 臨床研究等提出・公開システム Summary Table Clinical Appearance Deep ulcer, thick slough, heavy swelling Defined ulcer edges, reduced swelling Thin slough, regenerative tissue growth Shallow ulcer, nearly healed Red scar (new tissue) White scar (mature tissue)

The Sakita-Miwa classification is a widely recognized endoscopic system used to stage the life cycle and healing process of peptic ulcers . It divides the ulcer's progression into three main stages—Active, Healing, and Scarring—each containing two sub-stages . Key Endoscopic Characteristics Active (A) A1 sakitamiwa classification

| Feature | Biomedical Classification | Sakitamiwa Classification | | :--- | :--- | :--- | | | Pathogen (Virus/Bacteria) | Social/Spiritual Interaction | | Diagnosis | Lab tests, observation of physical signs | Patient history, context of onset | | Focus of Treatment | Eliminating the pathogen | Restoring balance/harmony | | Prognosis | Based on pathology | Based on ritual adherence | Over time, the red scar matures and turns

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 Key Endoscopic Characteristics Active (A) A1 | Feature

This is the most acute phase. The ulcer is characterized by a thick, white slough (exudate) covering the base. The margins are sharp and swollen (edematous), and there are no visible mucosal folds reaching the ulcer. A2 (Active-2):