Swallow-induced esophageal peristalsis is preceded by a wave of inhibition in the esophageal body. The aim of this study was to determine whether a similar wave of inhibition precedes secondary peristalsis. Primary and secondary peristalsis were studied in 6 healthy subjects. Inhibition was visualized as relaxation of an artificial high-pressure zone which was created in the esophageal body by the inflation of a small intraesophageal balloon. Secondary peristaltic contractions induced by injection of 10 ml of air in the proximal esophagus or secondary peristaltic contractions spontaneously occurring after repeated swallowing were preceded by inhibition similar to that observed in primary peristalsis (96.4 +/- 2.8%, 93.2 +/- 4.2% and 91.5 +/- 3.3%) respectively. It is concluded that physiologically triggered secondary peristaltic contractions are preceded by inhibition in the esophageal body.