Forrest classification is a classification of upper gastrointestinal hemorrhage used for purposes of comparison and in selecting patients for endoscopic treatment.^[1]

Acute hemorrhage

• Forrest I a (Spurting hemorrhage)
• Forrest I b (Oozing hemorrhage)

Signs of recent hemorrhage

• Forrest II a (Non bleeding Visible vessel)
• Forrest II b (Adherent clot)
• Forrest II c (Flat pigmented haematin (coffee ground base) on ulcer base)

Lesions without active bleeding

• Forrest III (Lesions without signs of recent hemorrhage or fibrin-covered clean ulcer base)^[2]

Forrest's classification is instrumental when stratifying patients with upper gastrointestinal hemorrhage into high and low risk categories for mortality. It is also a significant method of prediction of the risk of rebleeding and very often is used for evaluation of the endoscopic intervention modalities.^[3] A prospective controlled study revealed that "Forrest criteria are essential for proper planning of endoscopic therapy and urgent surgery in bleeding peptic ulcers".^[4]

The classification was first published by J.A. Forrest, et al. in the Lancet in 1974.^[5]

• Rockall score
• Glasgow-Blatchford

• Illustrated Forrest classification Archived 2020-02-21 at the Wayback Machine
• Forrest Classification System with Respective Prognosis