Esophagectomy provides the best chance for cure in patients who have early esophageal cancer but is an inherently life-altering operation. It reorders the patient’s ability to take in and digest food. In recent years, quality of life and functional status have emerged as important outcome measures. Unfortunately normal gastrointestinal function after an esophagectomy include dumping syndrome, delayed gastric emptying, reflux, and dysphagia. These problems often go undetected in the immediate postoperative period but can become progressively disabling over time. This article reviews these disorders with recommendations for avoidance and management.