GI MOTILITY
- Sundar Lal Mina
5 Stages of
Gastrointestinal
Motility Seen
1 Oral Stage of Gastric Motility
2 Pharyngeal Stage of Gastric Motility
3 Gastric (stomach) Stage of Gastric Motility
4 At Small Intestine
5 At Large Intestine
Oral Stage
Degluttion
Mastication
Process of food movement from the oral
cavity into the stomach.
Makes the swallowing of food easier.
Allows mixing of food with salivary
secretions
Increases surface area of food particles
which helps in subsequent digestion of
food in alimentary canal
Oral Stage
What happens in oral
stage?
Once the food is chewed thoroughly & mixed
with the saliva, it is rolled into a bolus.
Movement of tongue (upward & backward)
then presses this bolus against the hard
palate. The bolus is pushed back into the
pharynx, then pharyngeal stage begins.
This stage ensure that the food particles do not regurgitate from nose or
enter respiratory tract.
Step 1 Step 2
As soft palate is raised The epiglottis swings
upwards to close the backward over the opening of
posterior nares, so that Pharyngeal larynx. Vocals cords are
food does not regurgitates pulled medially to close
from nasal cavity Stage laryngeal opening.
Step 3 Step 4
These changes prevent The palate pharyngeal
entry of food particles into folds on each side of
the respiratory passage pharynx are pulled
medially to approximate
each other
• These folds form a sagittal slit through which the food must pass into
the posterior pharynx.
• Opening of esophagus is pulled up and enlarged. At the same tie, the
upper esophageal sphincter reflexes & allow food to move easily from
posterior pharynx to esophagus.
• A wave of contraction begins in pharynx and spreads down rapidly. It
propels the food into the esophagus.
2) By two types
1) Conduct food
of peristalsis
from pharynx
exhibited by
into stomach.
esophagus
3) The motor impulses
Esophageal Stage is transmitted via the
of Gastrointestinal IX and X Cranial
nerves and co-
Motility ordinated at the
brainstem swallowing
6)Relaxation of centre,
LES is mediated by
4) Lower esophageal
Vagus nerve 5) When peristaltic swallowing
sphincter (Gastro-
wave passes down the
esophageal phincter) is not
esophagus, there is receptive
an anatomical entity. The
relaxation of LES so the
esophageal circular muscle
swallowed food passes easily
functions as sphincter in this
into stomach
region
Peristaltic Wave Stomach
Bolus Oesophagus
At the Stomach
At The Stomach
0 0
1
Storage: Receptive
relaxation helps in
0 3
Slow Emptying:
Stomach stores food
storage and can for 4-6 hours.
accommodate 1-1.5 L
of content. 2
Mixing: Mixed
thoroughly with
gastric juices and
Gastric emptying
time is longest for
fats (~8 hours)
chyme formed.
Factors Factors
influencing inhibiting gastric
gastric emptying emptying
Gastric factors Acidic content of
like Gastrin. the chyme
When
CCK & Secretin toxic/irritants
are ingested
Hyperosmolarity
Movement in Large Intestine
Mixing Movement Propulsive Movement
In this case, it is
Haustrations. In this case, it is Mass
Movements.
Segmentation movement
occurs cause Mass movements are
unstimulated portion of modified type of
the large intestine to peristalsis seen in the
bulge outward into bag colon that helps propel
like sacs called fecal matter.
Haustrations.
And it finally ends with Defecation reflexes and thereby defecation
Haustrations Mass Movements
AB C D
Dysphagia Hunger Pangs Gastrocolic Reflex
Achalasia Cardia
Difficulties
A condition
in
swallowing.excessive
occur from aand
variety
of disorders.
When the stomach
in which
It may tone ofhas LES
After meals, as
been empty for stomach is
several hours,distended, there is
it does not relax
rhythmic peristaltic
during swallowing. initiation of mass
Clinicals
Food accumulatescontractions
in occur in
movements in the
esophagus.the body of stomach. colon.
They are initiated by
ANS.
Commonly occurs in
children.
A Dysphagia
B
Achalasia Cardia
C
Hunger Pangs
D
Gastrocolic Reflex
Difficulties in A condition in which When the stomach After meals, as
swallowing. It may excessive tone of LES has been empty for stomach is
occur from a variety and it does not relax several hours, distended, there is
of disorders. during swallowing. rhythmic peristaltic initiation of mass
Food accumulates in contractions occur in movements in the
esophagus. the body of stomach. colon.
They are initiated by
ANS.
Commonly occurs in
children.
ABCD
Summary
Dysphagia Hunger
Achalasia Gastrocolic
Pangs
Cardia Reflex
Difficulties When
A condition theAfter
stomach
in in which meals, as
swallowing. Ithas
excessive been
may
tone empty
stomach
of LES for is
occur from
and itadoes several
notdistended,
variety hours, there is
relax
during rhythmic
of disorders. initiation
peristaltic
swallowing. of mass
contractions
Food accumulates movements
inoccur inin the
the body of stomach.
esophagus. colon.
They are initiated by
ANS.
Commonly occurs in
children.
Summary
• Oral Stage of Gastrointestinal Motility
• Pharyngeal Stage of Gastrointestinal Motility
• Esophageal Stage of Gastrointestinal Motility
• Gastric Stage of Gastrointestinal Motility
• Motility in Small Intestine
• Motility in Large Intestine
• Clinical Aspects
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