A 60-yr-old woman with recurrent biliary-type pain and pancreatitis was found to have abnormal biliary manometrics. Sphincter of Oddi basal and phasic contraction pressures were significantly elevated. Esophageal manometrics revealed high amplitude peristaltic contractions that were unassociated with chest discomfort. High amplitude dysmotility syndromes may perhaps represent a spectrum of disease involving the entire gastrointestinal tract.