GI motility, swallowing and the enteric nervous system
How the enteric nervous system, interstitial cells of Cajal and extrinsic nerves coordinate swallowing, gastric emptying, the migrating motor complex and colonic transit, and how this explains achalasia, scleroderma oesophagus, gastroparesis, Hirschsprung disease and the actions of prokinetics, opioids and antiemetics.
Tier 2Medical sciences concept
Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made
At a glance
- The gut has its own nervous system of about 500 million neurons. The myenteric plexus runs motility and the submucosal plexus runs secretion. Extrinsic nerves modulate but are not required.
- Interstitial cells of Cajal generate slow waves that set the maximum contraction frequency. Contractions occur only when spikes ride on a slow wave.
- The basic unit is the peristaltic reflex: contraction above a bolus (acetylcholine, substance P) and relaxation below it (nitric oxide, VIP).
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Sources
- Abell TL, Camilleri M, Donohoe K et al. Consensus recommendations for gastric emptying scintigraphy. Am J Gastroenterol 2008;103:753-63American Journal of Gastroenterology, 2008
- Sleisenger and Fordtran's Gastrointestinal and Liver Disease (11th ed.)Elsevier (Feldman, Friedman, Brandt, 2021), 2021
- Guyton and Hall Textbook of Medical Physiology (14th ed.)Elsevier (Hall and Hall, 2021), 2021
- Yadlapati R et al. Esophageal motility disorders on high-resolution manometry: Chicago classification version 4.0. Neurogastroenterol Motil 2021;33(1):e14058International High Resolution Manometry Working Group, 2021
- Camilleri M et al. ACG Clinical Guideline: Gastroparesis. Am J Gastroenterol 2022;117(8):1197-220American College of Gastroenterology, 2022
- Last updated
- 14 November 2026
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