What is peristalsis?
Peristalsis is a type of involuntary muscle movement that occurs in your digestive system. It begins in your throat when you swallow, and continues to propel food and fluids throughout your gastrointestinal tract. You can think of your GI tract as a series of hollow organs joined together to form one long passageway. That passageway is lined with muscles and nerves. When food or fluids enter your GI tract, nerves trigger the muscles to initiate a series of wave-like contractions. These muscle contractions automatically move food and fluids forward until they reach their exit at your anus or urethra.
What is the difference between peristalsis and segmentation?
Segmentation is another kind of involuntary muscle movement that occurs in your digestive system. But unlike peristalsis, which occurs throughout your GI tract, segmentation occurs mainly in your intestines. Segmentation activates circular muscles in your intestines that contract to move food back and forth, a bit like the churning of a washing machine. This churning gives food in the intestines a chance to mix with gastric juices and helps break it down into smaller pieces for digestion. Segmentation slows the progress of food through your GI tract somewhat, but peristalsis continues to move it gradually along.
What is reverse peristalsis?
When the wave-like muscle contractions of peristalsis move backward instead of forward, it’s called retroperistalsis, antiperistalsis or reverse peristalsis. This is what happens when your vomiting reflex is triggered. Reverse peristalsis can move food backward all the way from your small intestine back through your stomach, esophagus and mouth. It can also occur on a smaller scale during food’s normal journey through the digestive tract if that journey encounters an obstruction along the way. Reverse peristalsis might move the food backward briefly for a small distance before reattempting forward motion.
What does peristalsis do for the body?
Peristalsis makes digestion possible. It’s what moves food and fluids through each stage of the digestive process. Without peristalsis, we could neither eat nor poop. The slow but steady progress of peristalsis is also important for digestive health. It gives your body time to break food down for digestion and to absorb nutrients along the way. But it's also responsible for clearing out accumulating bacteria and waste products in a timely manner. If peristalsis doesn’t take enough time for digestion, or if it takes too much time clearing the passageway, other digestive functions begin to break down along the way.
Where does peristalsis occur?
Peristalsis occurs throughout your GI tract, but especially in your esophagus. When you swallow, your throat (pharynx) begins the process by pushing food and fluids down into your esophagus (food pipe), which leads to your stomach. The esophagus has a primary peristaltic wave that’s triggered by swallowing, and a secondary one that kicks in when the first one isn't enough. The secondary one is triggered by the stretching of the esophagus walls when there's a large lump to swallow. Esophageal disorders involving peristalsis can cause swallowing problems.
After your esophagus, peristalsis continues through your stomach and both intestines, where the process slows down to allow for segmentation. During segmentation, peristalsis allows your gallbladder to move bile into your small intestine to aid with digestion. It also allows your kidneys to move fluids into your bladder. At the end of the digestive process, peristalsis in your urethra excretes urine from your body, and peristalsis in your rectum and anus excrete poop. When your digestive system is empty, such as during the night while you sleep, peristalsis continues to clear out excess residue.
What does peristalsis look like?
The muscle movements of peristalsis are often described as wave-like because they contract and relax in a continuous pattern to move food forward. They involve both the circular muscles that ring the tubes of your digestive tract and also longitudinal muscles that span the walls of the tubes. The circular muscles squeeze and expand in a synchronized way to push the food through the tube while the longitudinal muscles propel everything forward. The wave-like pattern is really more present earlier in the digestive process, though. Toward the end, it only takes a few contractions to push waste out.
Conditions and Disorders
What are the symptoms of peristalsis problems?
Problems with peristalsis are also called motility disorders. Motility is the movement of food through your GI tract. A problem with peristalsis usually results in motility that's too fast or too slow. Increased peristalsis is called hypermotility or hyperperistalsis. It leads to diarrhea and problems with digestion when the GI tract doesn’t have enough time to break food down properly and absorb its nutrients. Decreased peristalsis is called hypomotility or hypoperistalsis. It leads to constipation and bacterial overgrowth when peristalsis isn’t able to regularly clear out accumulated waste and bacteria.
Motility disorders can cause a variety of symptoms, including:
- Abdominal pain.
- Abdominal distension.
- Bloated stomach.
- Acid reflux.
- Dysphagia (difficulty swallowing).
- Nutritional deficiencies.
What causes problems with peristalsis?
Peristalsis occurs by a complex cooperation of muscles and nerves, which are governed by hormones. Problems with peristalsis can be related to your muscles or nervous system. They can occur in any part of your gastrointestinal tract, or throughout. Medications, injuries, infections and diseases, hormone fluctuations and electrolyte imbalances can all affect the muscles or nerves involved in peristalsis. Sometimes the cause of peristalsis problems is unknown (idiopathic). A number of gastrointestinal diseases are associated with peristalsis problems, but it’s not always clear which is the cause and which is the effect.
Medications that may affect peristalsis
- Opioid pain-relievers.
- Calcium channel blockers.
- Tricyclic antidepressants.
Conditions that may affect peristalsis
- Local infection or inflammation.
- Electrolyte deficiencies.
- Thyroid disease.
- Neurological disorders.
- Scleroderma and other connective tissue disorders.
- Intestinal ischemic syndrome.
- Chronic atrial and intestinal dysrhythmia (CAID).
- Hirschsprung disease.
What conditions does peristalsis affect?
Peristalsis problems may cause or contribute to the following conditions:
- Intestinal pseudo-obstruction.
- Esophageal spasms.
- Irritable bowel syndrome (IBS).
- Paralytic ileus.
How do you treat peristalsis problems?
Peristalsis problems are often complex, and treating them effectively requires understanding their causes. Sometimes it might be as simple as changing your medication or your diet. But conditions involving your nervous system can be trickier than that. Mental/emotional factors can play a part, along with hormones and electrolytes, and sorting these out can involve some trial and error. Sometimes peristalsis problems result from a larger condition that needs to be treated.
What medications are prescribed to treat motility disorders?
Depending on your condition, your healthcare provider may suggest:
- Parasympathomimetic drugs to activate the parasympathetic nervous system.
- Prokinetic agents to stimulate sluggish motility.
- Antidiarrheals to relieve diarrhea.
How can I maintain healthy peristalsis?
Under normal conditions, you can maintain healthy peristalsis with healthy lifestyle habits.
- Get some exercise: At least 30 minutes a day is ideal to stay regular.
- Drink enough water: At least 8 glasses a day helps keep things moving.
- Eat some fiber: Whole grains, fruits and vegetables add important bulk to stimulate peristalsis.
- Reduce processed foods: High fat content and refined carbohydrates slow digestion.
A note from Cleveland Clinic
Peristalsis is one of our body’s automatic functions. We rely on it every day without even thinking about it. But what do you do when peristalsis isn't working as it should? You can start with making some simple lifestyle changes. Consider the medications you are on and if they have known side effects on peristalsis. Finally, you can consult with a gastroenterologist. Peristalsis problems can have many causes, but medical testing and expertise can help you get to the bottom of it.
Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy