Current role of esophageal function studies.

The introduction of laparoscopic techniques for performing anti-reflux surgery has led to a significant increase in the number of such procedures being performed. Furthermore, the threshold of symptoms required for performance of such procedures seems to have been lowered. For these reasons, it is more important than ever to ensure that symptoms attributed to gastroesophageal reflux are appropriately evaluated for a high rate of clinical success after anti-reflux surgery. Clinical assessment requires a careful history, expert radiographic assessment, and endoscopy by an experienced observer. Objective measurements including esophageal manometry, acid perfusion studies, and 24-hour esophageal pH monitoring continue to play an important role in the diagnosis and management of associated functional disorders of the esophagus.