Context: Small volumes of pickle juice (PJ) relieve muscle cramps within 85 seconds of ingestion without significantly affecting plasma variables. This effect may be neurologic rather than metabolic. Understanding PJ's gastric emptying would help to strengthen this theory.Objective: To compare gastric emptying and plasma variables after PJ and deionized water (DIW) ingestion.Design: Crossover study. Setting: Laboratory.Patients or Other Participants: Ten men (age 5 25.4 6 0.7 years, height 5 177.1 6 1.6 cm, mass 5 78.1 6 3.6 kg).Intervention(s): Rested, euhydrated, and eunatremic participants ingested 7 mL?kg 21 body mass of PJ or DIW on separate days.Main Outcome Measure(s): Gastric volume was measured at 0, 5, 10, 20, and 30 minutes postingestion (using the phenol red dilution technique). Percentage changes in plasma volume and plasma sodium concentration were measured preingestion (245 minutes) and at 5, 10, 20, and 30 minutes postingestion.Results: Initial gastric volume was 624.5 6 27.4 mL for PJ and 659.5 6 43.8 mL for DIW (P . .05). Both fluids began to empty within the first 5 minutes (volume emptied: PJ 5 219.2 6 39.1 mL, DIW 5 305.0 6 40.5 mL, P , .05). Participants who ingested PJ did not empty further after the first 5 minutes (P . .05), whereas in those who ingested DIW, gastric volume decreased to 111.6 6 39.9 mL by 30 minutes (P , .05). The DIW group emptied faster than the PJ group between 20 and 30 minutes postingestion (P , .05). Within 5 minutes of PJ ingestion, plasma volume decreased 4.8% 6 1.6%, whereas plasma sodium concentration increased 1.6 6 0.5 mmol?L 21 (P , .05). Similar changes occurred after DIW ingestion. Calculated plasma sodium content was unchanged for both fluids (P . .05).Conclusions: The initial decrease in gastric volume with both fluids is likely attributable to gastric distension. Failure of the PJ group to empty afterward is likely due to PJ's osmolality and acidity. Cardiovascular reflexes resulting from gastric distension are likely responsible for the plasma volume shift and rise in plasma sodium concentration despite nonsignificant changes in plasma sodium content. These data support our theory that PJ does not relieve cramps via a metabolic mechanism.Key Words: acetic acid, electrolytes, sodium, stomach, vinegar Key Points N Ingestion of large volumes of pickle juice and deionized water resulted in initially similar gastric-emptying rates. N However, compared with ingestion of deionized water, gastric volume was greater at 20 and 30 minutes after ingestion of pickle juice. This difference is likely due to the osmolality and acidity of pickle juice.N After ingestion of pickle juice, gastric distension likely triggers cardiovascular reflexes, causing hypotonic fluid to shift out of the intravascular space. S keletal muscle cramps occurring during or shortly after exercise have been termed exercise-associated muscle cramps (EAMC). These cramps affect athletes including marathoners 1 and American football players. 2 Despite their prevalence, the cause of EAMC is unknow...