In addition to the transport of food and liquid from the mouth to the stomach by primary peristalsis, another important function of the esophagus is to prevent gastric contents that are refluxed into the esophagus from being aspirated into the airways. This function depends on secondary peristalsis and coordination with the esophageal sphincters, which is stimulated by distention of the body of the esophagus by gastric refluxate. This article reviews primary and secondary peristalsis and sphincter function and the various reflexes that are induced by distention of the esophagus. Extra-esophageal effects of esophageal distention are also reviewed.