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Concomitant esophageal dysmotility can be present in up to 2/3 of patients with EoE and GERD. Esophageal dysmotility contribute to symptoms in these patients and can be a reason for a suboptimal response to therapy. Mechanisms for dysfunction of esophageal smooth muscle function in EoE and GERD have been studied in bench models of human esophageal tissues. Understanding and targeting these mechanisms therapeutically may improve symptomatic outcomes in what are otherwise considered mucosal esophageal diseases.