[Functional disorders of the esophagus. Diagnosis and therapy]

Functional disorders of the esophagus may be divided into alterations of the pharyngeal and upper esophageal sphincter motor function, malfunction of the tubular esophagus and disorders of the lower esophageal sphincter. Radiology, endoscopy and manometry are essential in the evaluation of the individual patient, in lower esophageal sphincter insufficiency with reflux disease acid clearance, reflux provocation test, acid perfusion and pH metry should be added. Conservative vs. operative therapy has to be critically evaluated. The diagnostic criteria of the most common functional disturbances like idiopathic diffuse esophageal spasm, achalasia and scleroderma are presented and therapeutic efforts discussed.