title: Response of esophagus to high and low temperatures in patients with achalasia.
abstract: OBJECTIVE
  Achalasia patients would feel exacerbated dysphagia, chest pain and regurgitation when they drink cold beverages or eat cold food. But these symptoms would relieve when they drink hot water. Reasons are unknown.
  
  
  METHODS
  Twelve achalasia patients (mean age, 34 ± 10 years; F:M, 3:9) who never had any invasive therapies were chosen from Peking Union Medical College Hospital. They were asked to fill in the questionnaire on eating habits including food temperature and related symptoms and to receive high-resolution manometry examination. The exam was done in 2 separated days, at swallowing room temperature (25℃) then hot (50℃) water, and at room temperature (25℃) then cold (2℃) water, respectively. Parameters associated with esophageal motility were analyzed.
  
  
  RESULTS
  Most patients (9/12) reported discomfort when they ate cold food. All patients reported no additional discomfort when they ate hot food. Drinking hot water was effective in 5/8 patients who ever tried to relieve chest pain attacks. On manometry, cold water increased lower esophageal sphincter (LES) resting pressure (P = 0.003), and prolonged the duration of esophageal body contraction (P = 0.002). Hot water decreased LES resting pressure and residue pressure during swallow (P = 0.008 and P = 0.002), increased LES relaxation rate (P = 0.029) and shortened the duration of esophageal body contraction (P = 0.003).
  
  
  CONCLUSIONS
  Cold water could increase LES resting pressure, prolong the contraction duration of esophageal body, and exacerbate achalasia symptoms. Hot water could reduce LES resting pressure, assist LES relaxation, shorten the contraction duration of esophageal body and relieve symptoms. Thus achalasia patients are recommended to eat hot and warm food and avoid cold food.
authors.affiliation: Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing, China. ; Department of Gastroenterology, Nanfang Hospital, Southern Medical University, Guangzhou, China.
authors.forename: Yutang
authors.initials: Y
authors.lastname: Ren
authors.forename: Meiyun
authors.initials: M
authors.lastname: Ke
authors.forename: Xiucai
authors.initials: X
authors.lastname: Fang
authors.forename: Liming
authors.initials: L
authors.lastname: Zhu
authors.forename: Xiaohong
authors.initials: X
authors.lastname: Sun
authors.forename: Zhifeng
authors.initials: Z
authors.lastname: Wang
authors.forename: Ruifeng
authors.initials: R
authors.lastname: Wang
authors.forename: Zhao
authors.initials: Z
authors.lastname: Wei
authors.forename: Ping
authors.initials: P
authors.lastname: Wen
authors.forename: Haiwei
authors.initials: H
authors.lastname: Xin
authors.forename: Min
authors.initials: M
authors.lastname: Chang
keywords: Esophageal achalasia; Esophageal motility disorders; Food; Temperature