Stages of Gastric Ulcers

Gastric ulcers are classified into three main stages based on their pathological development: the active stage, the healing stage, and the scar stage. Each stage reflects a different phase in the progression or recovery of the ulcer.

The Active Stage (A-Stage)
The active stage is further divided into two sub-stages: A1 and A2. In the A1 stage, the mucosa surrounding the ulcer is significantly swollen, and the base of the ulcer is covered with yellow or white exudate, indicating active inflammation. As the condition progresses to A2, signs of healing begin to appear. The exudate starts to decrease, and the edges of the ulcer become redder and less inflamed, suggesting the beginning of tissue repair.

The Healing Stage (H-Stage)
This stage marks the start of mucosal regeneration. It includes H1 and H2 phases. During H1, the ulcer begins to shrink in size, and a red halo forms around the lesion as new epithelial cells grow. The healing process typically moves from the edges toward the center. In H2, the ulcer bed is completely covered by regenerated epithelium, indicating that the wound has closed, although the tissue may still appear reddish compared to normal mucosa.

The Scar Stage
In this final stage, the healed ulcer leaves behind a visible scar. Initially, the scar appears red and is referred to as Stage I. Over time, during Stage II, the redness fades and the area turns white or pale, signifying full healing at both the structural and histological levels. This classification helps doctors monitor ulcer progression and response to treatment using endoscopic evaluation.

Understanding these stages is crucial for effective diagnosis and management of gastric ulcers, allowing healthcare providers to tailor therapy based on the current state of the disease.