Question: A 74-year-elderly woman was presented to the clinic to be treated for dysphagia, which had persisted for more than 5 years. Previously, repetitive botulinum injections for suspected hypercontractile esophagus had been implemented in an external clinic without any success. The present esophagogastroduodenoscopy revealed an elongated esophagus with tertiary contractions and reflux stage A according to the Los Angeles classification. Eosinophilic esophagitis was excluded histologically, and laboratory results showed no relevant pathologies.