Peristalsis: How Food Moves Through Your Digestive System

Peristalsis describes the involuntary wave of muscle contractions that happen naturally in your digestive tract. This automatic bodily function physically moves food and drink through your body—from the time you initially swallow it until it exits your body through your anus or urethra.

Certain digestive disorders or medications can disrupt peristalsis, preventing the muscle reflex from flowing properly. A healthcare provider can help determine the underlying cause of peristalsis issues and recommend medications, lifestyle modifications, or, in some cases, procedures to help keep your digestive system moving smoothly.

What Does It Feel Like?

As your body's natural peristalsis process helps push and flow what you've consumed through the digestive tract, you may notice some signs of movement—like a wave of gas in certain parts of the abdomen, for example.

Otherwise, peristalsis is normal and shouldn't come with other symptoms. However, you may experience certain symptoms if something is disrupting peristalsis. Signs that something is wrong with the way that peristalsis is working in the body include:

• Constant or frequent diarrhea
• Constipation
• Chest pain
• Dysphagia (difficulty swallowing)
• Heartburn
• Vomiting
  

What Causes Peristalsis?

Peristalsis is an involuntary or automatic process, which means you aren't consciously creating that muscle movement. When you eat or drink something, the nervous system stimulates the muscles in the digestive tract, which then triggers peristalsis to start.

Once it starts, peristalsis moves food down through your esophagus, stomach, small intestine, and large intestine before excretion through the anus (a bowel movement, or poop).

Drinking only liquids can also trigger peristalsis. The muscle contractions help push fluids through your kidneys to your bladder before the fluid eventually leaves your body through your urethra as urine (pee).

Causes of Gut Motility Issues

Although peristalsis is normal and necessary, some people can experience issues with the process. This can be a sign of a motility disorder or a disruption in peristalsis contractions. Some of these disorders include:

• Achalasia: A swallowing disorder associated with problems with peristalsis in the esophagus
• Dysphagia: Difficulty swallowing often linked to problems with peristalsis in the esophagus
• Gastroesophageal reflux disease (GERD): A condition in which stomach acid flows back up into the esophagus
• Gastroparesis: A condition where the stomach doesn't empty as quickly as it should, potentially involving peristalsis dysfunction
• Irritable bowel syndrome (IBS): A condition that triggers diarrhea and constipation as a potential result of peristalsis moving too quickly or too slowly

Certain infections (like a Candida fungal infection) or a medication side effect—like from narcotic pain relievers, calcium channel blockers, or non-steroidal anti-inflammatory drugs (NSAIDs)—can also cause peristalsis issues.

Diagnosis

A healthcare provider will perform a physical examination and ask about your symptoms and medical history. After that, they may diagnose a potential motility disorder and peristalsis issue through a series of tests, including:

• Esophageal manometry: This pressure recording test shows how coordinated your esophagus's muscle movement waves are. Similar tests are available for the stomach, small intestine, large intestine, and anus.
• Esophageal pH test: A medical professional will use a flexible tool to check how much stomach acid enters your esophagus and how long it remains there. This test often helps diagnose peristalsis-related disorders like GERD.
• Barium swallow test (esophagram): During this test, you will swallow a liquid containing a soft metal called barium to coat your esophagus and upper gastrointestinal tract. The provider will then take an X-ray while you swallow to see how the liquid moves down the throat.
• Endoscopy: During this test, a medical professional will insert a thin, flexible tube with a camera on the end of it (known as an endoscope) down your throat and into your esophagus and stomach to help visualize any issues or abnormalities.

Treatments for Peristalsis Issues

A goal of treatment for peristalsis-related issues is to help restore motility back to normal function. The exact type of treatment for a digestive disorder related to a peristalsis issue will vary based on the underlying condition and its specific symptoms.

Medications

Depending on the cause of the peristalsis disruption, your provider may prescribe certain medications to help improve motility, including:

• Acid-reducing medications such as antacids or proton pump inhibitors may be helpful to ease peristalsis difficulties related to conditions like GERD
• Medications to treat diarrhea or constipation
• Calcium channel blockers and nitrates to relax the digestive muscles
• Antispasmodic drugs like dicyclomine (Bentyl) to help reduce muscle spasms in the esophagus
• Botulinum toxin injections in certain parts of the digestive tract to potentially help move food and drink through the digestive tract more smoothly

Lifestyle and Dietary Modifications

You may be able to manage the symptoms of some motility disorders involving the esophagus with lifestyle and dietary tweaks, such as:

• Eating smaller, more frequent meals
• Avoiding foods that trigger your specific digestive concerns
• Checking with a healthcare provider about reducing or replacing medications that may be impacting motility
• Trying peppermint oil before meals to potentially help slow esophageal contractions, for issues where motility is happening too quickly

Surgery

In rare or severe cases, a healthcare provider may recommend surgical or endoscopic (less-invasive) procedures for peristalsis issues. For example, conditions like achalasia and dysphagia may benefit from certain surgeries to help adjust muscles in certain parts of the digestive tract. However, these procedures are typically a last resort.

Prevention

In most cases, you cannot prevent issues with peristalsis. However, experts do recommend some steps that may help limit any challenges with peristalsis passing food through the digestive system. These include:

• Maintain a healthful diet and adjust any eating habits that may be harming your gut health
• Limit excessive smoking or drinking
• Avoid unnecessary medication use
• Get plenty of exercise per day to help keep the digestive system regular
• Treat any underlying health conditions to prevent potential damage to the gut
  

Complications

If you have a condition that causes issues with peristalsis, leaving it untreated can lead to complications that impact your gut and overall health.

Potential complications may include:

• Esophagitis: Inflammation that damages the tissue in the esophagus
• Aspiration pneumonia: Food or liquid is accidentally inhaled into the lungs
• Esophageal stricture: Scarring or abnormal tissue growth in the esophagus

In rare cases, esophageal cancer due to damage from a condition like GERD may also develop without proper treatment.

A Quick Review

Peristalsis is an automatic body function that involves muscle contractions to push food and drink through the digestive tract. It's mostly unnoticeable unless there's an issue. Some digestive disorders or medication side effects can affect the way that peristalsis works.

A healthcare provider can help determine the root cause of any peristalsis problems and recommend treatment such as lifestyle tweaks, medications, or, in severe cases, procedures.