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March 12, 1982

Pain From Swallowing Cold Liquids

Author Affiliations

Bowman Gray School of Medicine Wake Forest University Winston-Salem, NC

JAMA. 1982;247(10):1406-1407. doi:10.1001/jama.1982.03320350020012

To the Editor.—  The results of Col George W. Meyer, MC, USAF, and Donald O. Castell, MD, concerning the effects of swallowing cold liquids on esophageal motility in man certainly contribute to a better understanding of cold-induced esophageal pain. The widely held assumption that chest pain resulting from ingestion of cold liquids was due to esophageal spasm has been purely speculative.We have recently published our results on the radiographic effects of cold barium suspensions on esophageal motility1 and agree completely with the conclusions of Drs Meyer and Castell. In 70 patients without esophageal symptoms, baseline esophageal peristalsis was assessed radiographically with barium at room temperature. Twenty-eight patients were reexamined with chilled barium (4 °C), while the remainder were reassessed with iced barium (3 °C), and the results showed reduction of primary peristalsis in each group by 45% and 58%, respectively.In most of our patients, the esophagus assumed