Enteric nervous system pathways mediating colonic peristalsis (ENS pathways)

The enteric nervous system (ENS) pathways mediating colonic peristalsis comprise an integrated neural circuit within the bowel wall that coordinates the propulsion of luminal contents (Furness, 2012, PMID: 22233379). This autonomous system, often termed the second brain, utilizes intrinsic primary afferent neurons (IPANs) to sense mechanical or chemical stimuli, which then trigger a reflex arc involving ascending excitatory interneurons and descending inhibitory interneurons (Grider, 2003, PMID: 12810408). The resulting motor output involves the release of acetylcholine and tachykinins to contract circular muscle proximal to the bolus, while nitric oxide and vasoactive intestinal peptide (VIP) relax the muscle distally (Spencer et al., 2016, PMID: 27073082). Dysregulation of these pathways is central to the pathophysiology of functional gastrointestinal disorders, such as chronic idiopathic constipation (CIC) and irritable bowel syndrome (IBS) (Camilleri, 2021, PMID: 33538315). Pharmacological modulation of these pathways typically involves targeting specific receptors, such as 5-HT4 receptors to promote neurotransmitter release or mu-opioid receptors to inhibit excessive motility. These pathways are critical targets for prokinetic and antidiarrheal therapies, offering a way to manage gastrointestinal transit without significant central nervous system involvement.

Other names

Myenteric plexus pathwaysPeristaltic reflex arcIntrinsic primary afferent neuron circuitsGastrointestinal motility pathwaysEnteric neural circuits

Modulation of enteric neurotransmission and smooth muscle activity via activation or inhibition of specific receptors (e.g., 5-HT4, GC-C, mu-opioid) to coordinate the contraction and relaxation phases of peristalsis.