Human esophageal response during chest pain induced by swallowing cold liquids

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Abstract
Normal persons often note chest or back pain during rapid ingestion of cold liquids, commonly believed to result from cold-induced spasm of esophageal muscle. The effects of swallowing cold liquids on esophageal function was studied in 5 normal subjects, aged 20-44 yr, by comparing their response to cold ice cream (-5.degree. C) and room temperature ice cream mix (20.degree. C). Decreased peristaltic amplitude was seen during cold ice cream ingestion, primarily in the midesophagus. When 7 subjects rapidly ingested ice cream until chest pain was produced and maintained for at least 60 s, complete absence of motor activity in the distal esophagus occurred, with slow return to normal during the ensuing 5 min. Ingestion of cold liquids significantly depresses peristaltic amplitudes and frequency of peristalsis in normal persons and pain is associated with complete absence of motor activity in the body of the esophagus, rather than esophageal spasm as commonly believed.

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