A cool esophagus is not necessarily heartburn. If it is caused by physiological factors such as diet, there is usually no heartburn, but if it is caused by pathological factors such as lesions of the esophagus itself or gastric diseases, heartburn may occur. 1. Physiological factors: If you eat a lot of cold food, such as cold drinks, ice cream, etc., or consume mint and other foods with a cooling sensation, it will stimulate the esophageal mucosa and lower the local temperature, thus feeling the esophagus cold. When there is tension, anxiety and other adverse emotions, it will make the esophagus of the vegetative nerve dysfunction, resulting in the esophagus of local blood flow is insufficient, the esophagus cool feeling. These are generally physiologic, and patients usually do not experience heartburn, that is, a burning sensation behind the sternum, and are not accompanied by other discomforts. 2. Lesions in the esophagus itself: such as esophagitis, esophageal cancer, etc., the mucous membrane of the esophagus of the patient will be damaged under the stimulation of inflammation, tumor and other factors, which will make the patient feel that the esophagus is cool. At this time, patients may also have acid reflux, heartburn and other feelings, accompanied by pain in swallowing, difficulty in swallowing and other discomforts in the esophagus. 3. Gastric diseases: such as chronic gastritis, patients are usually accompanied by increased secretion of gastric acid, or reflux of gastric contents and other symptoms, which can produce stimulation of the esophageal mucosa, the esophagus cool feeling, accompanied by acid reflux, heartburn and other symptoms. At this time, the patient may also be accompanied by belching, abdominal pain and distension, nausea and vomiting and other symptoms. If the patient has long-term or recurrent esophageal coolness or heartburn, it is recommended to consult a doctor in time to identify the cause of the disease and carry out targeted treatment, so as to avoid delaying the condition.