What is the Difference Between Primary and Secondary Peristalsis?

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Primary peristalsis is initiated by a swallow and is the main source of esophageal transit, pushing the ingested food bolus towards the stomach. On the other hand, secondary peristalsis is induced by esophageal distention and serves to maintain an empty esophagus by clearing refluxate from the stomach in the absence of swallowing.

Key differences between primary and secondary peristalsis include:

  • Initiation: Primary peristalsis is initiated by swallowing, while secondary peristalsis is induced by esophageal distention.
  • Control: Primary peristalsis is controlled by the swallowing center and coordinated by the myenteric plexus, whereas secondary peristalsis is largely an intrinsic neuromuscular reflex.
  • Contraction Characteristics: Esophageal primary peristaltic contractions are more forceful, with longer duration and higher work output compared to secondary peristalsis contractions.
  • Function: Primary peristalsis is responsible for transporting food from the mouth to the stomach, while secondary peristalsis functions to maintain an empty esophagus by clearing refluxate from the stomach.

Comparative Table: Primary vs Secondary Peristalsis

Here is a table summarizing the differences between primary and secondary peristalsis:

Feature Primary Peristalsis Secondary Peristalsis
Induction Swallowing Esophageal distension
Prominence More prominent Less prominent
Contraction More efficient, higher amplitudes, work output, and contractile tension Less efficient, lower amplitudes, work output, and contractile tension
Duration Longer Shorter
Initiation Initiated by a swallow Induced by distension-induced peristalsis, mechanical distention, or water infusion

Primary peristalsis is induced by swallowing and is the main source of esophageal transit, while secondary peristalsis is induced by esophageal distension and serves as a backup mechanism. Primary peristalsis has more efficient contractions with higher amplitudes, work output, and contractile tension, whereas secondary peristalsis has less efficient contractions with lower amplitudes, work output, and contractile tension.