Background: With loss or major dysfunction of the lower esophageal sphincter, esophageal motility belongs to the substantial remaining factors of antireflux activity. The aim of this study was to examine the influence of gastrectomy, reconstruction procedere and occurrence of postoperative reflux esophagitis on esophageal motility. Material and methods: Esophageal manometry with a gas perfused system was performed in 37 patients after total gastrectomy and 31 healthy controls. Esophageal motility was investigated and compared with regard to reconstruction type and occurrence of esophagitis. Results: Patients showed a significantly more frequent occurence of pathological patterns of contractions (37% vs. 9%, p Conclusions: After total gastrectomy, ineffective esophageal motility with increase of non-propulsive peristalsis and reduction of amplitudes and duration of contrations occurred. These changes were less pronounced in patients with pouch compared to those without pouch reconstruction. However, occurrence of reflux esophagitis after gastrectomy did not seem to be a consequence of disturbed esophageal motility after gastrectomy.