PURPOSE OF REVIEW Gastroesophageal reflux disease (GERD) is a commonly recognized cause of dysphagia. Conversely, eosinophilic esophagitis (EoE) and celiac disease are rarer and often overlooked as dysphagia culprits. Overlap between these conditions complicates diagnosis and delays appropriate treatment. This review aims to clarify the distinctive dysphagia characteristics in each condition, explore potential overlaps, and offer guidance on differentiation. RECENT FINDINGS Recent studies have advanced our understanding of dysphagia mechanisms in GERD, EoE, and celiac disease, particularly in characterizing disordered motility and dysphagia's natural history. While upper endoscopy, biopsies, and manometry remain crucial in dysphagia assessment, novel diagnostic tools are emerging. New insights highlight the significance of cytokine-induced mucosal injury in all three conditions, revealing potential connections where mucosal damage in one disorder may contribute to the development of others. SUMMARY GERD, EoE, and celiac disease can coexist and present with similar symptoms. Distinguishing between them often entails upper endoscopy, esophageal biopsies, pH testing, and celiac serologies. EoE should be considered when GERD patients fail proton pump inhibitor therapy or when celiac patients have persistent esophageal symptoms despite a gluten-free diet. Consider celiac disease if dysphagia accompanies iron deficiency anemia, malabsorptive diarrhea, or osteoporosis. Recognizing the potential overlap between these conditions is crucial for guiding clinical evaluation and therapy.

中文翻译：

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反流、嗜酸性粒细胞性食管炎和乳糜泻 - 模糊的界限。


综述目的 胃食管反流病 （GERD） 是公认的吞咽困难的常见原因。相反，嗜酸性粒细胞性食管炎 （EoE） 和乳糜泻更为罕见，经常被忽视为吞咽困难的罪魁祸首。这些情况之间的重叠使诊断复杂化并延误适当的治疗。本综述旨在阐明每种情况下独特的吞咽困难特征，探讨潜在的重叠，并提供鉴别指导。最近的发现最近的研究加深了我们对 GERD、EoE 和乳糜泻中吞咽困难机制的理解，特别是在表征运动障碍和吞咽困难的自然史方面。虽然上消化道内窥镜检查、活检和测压在吞咽困难评估中仍然至关重要，但新的诊断工具正在出现。新的见解强调了细胞因子诱导的粘膜损伤在所有三种情况下的重要性，揭示了一种疾病中的粘膜损伤可能导致其他疾病发展的潜在联系。摘要 GERD、EoE 和乳糜泻可以共存并出现相似的症状。鉴别它们通常需要上消化道内窥镜检查、食管活检、pH 值检测和乳糜泻血清学检查。当 GERD 患者质子泵抑制剂治疗失败或乳糜泻患者尽管无麸质饮食但仍有持续性食管症状时，应考虑 EoE。如果吞咽困难伴有缺铁性贫血、吸收不良性腹泻或骨质疏松症，则考虑乳糜泻。认识到这些情况之间的潜在重叠对于指导临床评估和治疗至关重要。