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🩸 Forrest Classification (UGI Bleed)

Classify peptic ulcer bleeding endoscopically and estimate rebleed risk (Forrest).

Forrest Classification (UGI Bleed)

Endoscopic appearance

When to use

Guide endoscopic therapy and PPI strategy in ulcer bleeding.

How it works

Ia spurting / Ib oozing / IIa visible vessel (high risk); IIb clot (intermediate); IIc flat spot / III clean base (low risk).

Key points

  • High-risk stigmata (Ia–IIa) need endoscopic haemostasis + IV PPI.
  • Low-risk lesions: oral PPI, early feeding/discharge.
  • Adherent clot (IIb): consider removal and treat the lesion.

References

Decision support for licensed clinicians only; not a substitute for clinical judgement, diagnosis or local protocols.

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