These constrictions passing backward over the colon do not force
the normal contents back through the valve into the small intestine
again. I have seen hundreds of such constrictions, and only twice have
there been exceptions to this rule,--once under normal conditions,
when a small mass slipped back into the ileum, and at another time
when a large amount of water had been introduced into the colon. The
importance of the competence of the ileocæcal valve is now apparent;
indeed, antiperistalsis in the colon gives new meaning and value to
the location of a valve at the opening of the ileum. For, inasmuch
as the valve is normally competent, the constrictions repeatedly
coursing towards it force the food before them into a blind sac. The
effect on the food must be the same as the effect seen in the stomach
when the pylorus remains closed before the advancing waves. The food
is pressed forward by the approach of each constriction; but since
it cannot go onward in the blind sac, and is, moreover, subjected to
increasing pressure as the constriction comes nearer, it is forced
into the only way of escape, _i. e._, away from the cæcum through
the advancing constricted ring. About twenty-five waves affect every
particle of food in the colon in this manner during each normal period
of antiperistalsis. The result must be again a thorough mixing of the
contents and a bringing of these contents into close contact with the
absorbing wall--a process which has already been variously repeated
many times in the stomach and in the small intestine.
Public-domain text, read in full here on John Shaqi.
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