The results of this study demonstrate that there is abnormal esophageal function in patients who have undergone repair of esophageal atresia. The diagnostic tests used may be too sensitive as the abnormalities demonstrated have little clinical relevance. In addition, there was an inverse relationship between signs and symptoms of esophageal dysfunction and the age of the child. The abnormalities are probably intrinsic and only secondarily affected by surgical treatment. Increased tension at the gastroesophageal junction is a likely factor in the production of gastroesophageal reflux. Esophageal dysfunction does not necessarily lead to detrimental gastroesophageal reflux with the sequela of repeated respiratory infections, failure to gain weight or esophageal stricture. Only patients who have such signs or symptoms need to undergo evaluation of esophageal function to determine if there is an abnormality. The results of the studies then document the need for an antireflux procedure.