Thirteen patients with gastroesophageal reflux disease underwent esophageal manometric evaluation during acute exacerbations and disease remission to evaluate lower esophageal sphincter and peristaltic pressure in response to treatment. No change was noted in lower esophageal sphincter pressure (15.2 +/- 2.6 mg versus 14.3 +/- 1.8 mm Hg) or peristaltic pressure (64.1 +/- 6.9 versus 62.1 +/- 7/8 mm Hg) with remission while both lower esophageal sphincter pressure and distal amplitude were lower in reflux patients than controls (p less than 0.05). Short-term treatment resulting in endoscopic and symptom improvement of gastroesophageal reflux disease does not appear to improve lower esophageal sphincter and peristaltic pressure.