Esophageal manometry and 24 hour pH monitoring were performed in elderly control group,non elderly control group,elderly and non elderly gastroesophageal reflux disease (GERD) patients with or without sliding hiatal hernia(HH).Elderly patients with GERD and HH showed a lower LESP compared with elderly GERD patients without HH and elderly controls.Non elderly patients with GERD and HH also showed a lower LESP compared with non elderly controls.Elderly GERD patients with HH showed a lower pressure of contraction at the distal esophagus compared with elderly GERD patients without HH.Extent of reflux had no difference between elderly GERD patients with and without HH.The results suggested that HH affect esophageal antireflux function and peristalsis of the distal esophagus in elderly and non elderly GERD patients,especially in elderly GERD patients,but it could not significantly increase esophageal acid exposure in elderly GERD patients.