Question: A 39-year-old Hispanic woman, presented in her 8th week of her first pregnancy with intermittent dysphagia and acid reflux. She had been experiencing these symptoms for several months, without vomiting or regurgitation, and had recently had an upper GI series (Figure A), in what would become the week of pregnancy conception, which showed only mild reflux with no stricture or emptying delay. Her past medical history was significant only for prior breast augmentation; she born in Columbia but had not been out of the United States in many years.