A 26-year-old man presented with a 3-year history of solid dysphagia and a 30-kg weight loss. He also complained of heartburn and regurgitation, especially at night. The patient was referred to the outpatient clinic and treated with oral nifedipine, isosorbide, and omeprazole, without resolution of symptoms. The history of past illness was unremarkable. The personal and family history was negative for gastrointestinal and endocrine disease. The Physical examination upon admission revealed a thin patient. No lumps or abdominal tumors were detected. Routine blood tests, routine urine tests and urinary sediment examination, routine fecal tests and occult blood test, blood biochemistry, immune indexes, and infection indexes – all were within normal limits. An upper gastrointestinal series (barium swallow) revealed a “bird’s beak” sign.