Mechanism and Function of Peristalsis

The autonomous nervous system controls peristalsis. The enteric division of the autonomous nervous system forms a network of neurons that spread along the gut walls. The network spreads over the myenteric plexus, which coordinates the peristalsis. Once completely swallowed food enters the esophagus, the longitudinal and circular muscles undergo a reflexive action due to the sensitivity of neurons present in them. This results in the production of wave-like contractions within the digestive sites and some hollow tubes.

The peristaltic waves impel the food and liquid to reach the stomach and other parts of the digestive system. They occur in two phases called the primary peristaltic waves and the secondary peristaltic waves. The single wave of peristalsis guides the food through the digestive tract, and the secondary wave ensures the elimination of leftover food particles in the tract. Also, the peristaltic waves vanish when the stomach gets filled with the excess fat present in food. The filling of the stomach stops the waves from pushing more food until the former food particles get diluted with gastric juices. The peristaltic waves in the stomach help mix gastric juices and food particles for complete digestion. In the intestine, the peristalsis helps in the complete digestion of partially digested food and absorbing nutrients into blood. Peristalsis in the large intestine helps in the egestion of the waste food. Dysfunction in peristalsis can lead to constipation or diarrhea due to motility disorder.

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Sites of Peristalsis
Peristalsis occurs throughout the digestive tract, from food pipe to stomach, stomach to intestines, and then to the rectus. The major sites of peristalsis are discussed as follows:

Peristalsis in the digestive system:

Esophageal peristalsis initiates in the superior part of the food pipe. The waves travel through the complete length of the pipe and push the food downward towards the stomach. As a result, the food particles become softer and take the shape of a ball. This ball of food particles is called a bolus.

Peristalsis in the stomach occurs when a bolus induces compression of stomach muscles. The peristalsis in the stomach helps break down food and mix gastric juices with the food. The peristaltic waves are stronger in the distal region of the stomach as compared to the beginning regions. Pepsin enzyme present in the stomach converts the bolus of food into a chime. The chime is then further pushed down into the duodenum of the small intestine.

Intestinal peristalsis involves the small intestine and the large intestine. The peristaltic movements in the small intestine are slower. The chime travels only a few centimeters per second. This is because food in the small intestine needs to get absorbed by the intestinal hairs called villi. The slower movement ensures the complete breakdown of nutrients in the food that blood can easily absorb. Once complete, digestion and absorption occur, the chime travels to the large intestine.

Peristalsis in the large intestine occurs only once or twice a day. This ensures that the undigested food waste should travel towards the rectum for egestion in the form of feces.

Reverse Peristalsis and Peristalsis in the Urinary Tract
Peristalsis in the urinary tract is necessary for expelling out urine from the kidney. The peristaltic waves guide the urine to pass from the two ureters to the bladder. Finally, peristaltic waves in the bladder expel the urine out from the body through the urethra.

The reverse peristalsis is usually performed in cud-chewing animals like cattle. These animals do reverse peristalsis to revert food into the mouth for extended chewing. However, in humans, if peristaltic waves work in opposite directions, they can lead to discomforts. Due to reverse peristalsis, the food present in a digestive tract or pipe is forced out backward. Reverse peristalsis occurs as a precursor of vomiting. Food poisoning, bloody ulcers in the gastrointestinal tract, or irritation of the stomach can cause reverse peristalsis resulting in induction of the emetic region of the brain. The brain responses to the trigger by producing an immediate vomiting reflex.

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