Diagnostic Reframing of Dysphagia: From Presumed Reflux to Eosinophilic Oesophagitis in an Otolaryngology Context

Abstract

Bruce H. Knox

Background: Dysphagia presenting to otolaryngology services is frequently attributed to laryngopharyngeal reflux (LPR). However, Eosinophilic esophagitis (EoE) may mimic reflux-related symptoms, leading to diagnostic delay.

Objective: To examine the consequences of reflux-based diagnostic anchoring in a patient whose symptoms improved following Gastric peroral endoscopic myotomy yet were ultimately attributable to EoE.

Methods: Narrative-informed clinical analysis supported by current literature, with emphasis on ENT-relevant presentation and diagnostic pathways.

Results: Symptom overlap between LPR, motility disorders, and EoE contributed to misattribution. Apparent clinical improvement after G-POEM created false diagnostic closure, delaying histological diagnosis.

Conclusion: Persistent dysphagia in ENT practice requires early endoscopic evaluation with biopsy. Symptom response to reflux- directed therapy should not exclude EoE.

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