Temperature-dependent symptoms in a patient with esophageal motor disease.

Patients with esophageal motor disease have been known to develop symptoms (chest pain, or dysphagia, or both) upon ingestion of warm or cold beverages. A patient with an esophageal motor disorder is described from whom a history of marked symptoms related to bolus temperature was elicited. Manometric monitoring during the administration of wet swallows with cold and warm water boluses reproducibly altered primary swallows from normal amplitude (74 +/- 7 mmHg) peristaltic contractions (warm boluses) to low amplitude (9 +/- 1.0 mmHg) aperistaltic contractions (cold boluses). The striking correlation between clinical history and manometric findings supports altered peristalsis as one mechanism for the development of symptoms related to bolus temperature in patients with esophageal motor disease.