A patient who recently began having mild symptoms of GERD is reluctant to take medication. What measures will the nurse recommend to minimize this patient's symptoms? (Select all that apply.)

A. Avoiding hot, spicy foods Spicy foods can increase the production of stomach acid and may irritate the esophagus, worsening GERD symptoms. Avoiding hot and spicy foods is a dietary measure to minimize the risk of symptom exacerbation. B. Avoiding tobacco products Tobacco use is a known risk factor for GERD. Smoking can relax the lower esophageal sphincter (LES), allowing stomach acid to flow back into the esophagus. Advising the patient to quit or avoid tobacco products can contribute to symptom management. C. Drinking a glass of red wine with dinner While red wine may have some potential benefits, alcohol, in general, can relax the LES, leading to increased reflux. Therefore, drinking red wine with dinner may not be recommended for someone experiencing GERD symptoms. D. Eating a snack before bedtime Eating close to bedtime can increase the likelihood of GERD symptoms, as lying down may allow stomach acid to flow back into the esophagus. The nurse may advise against eating a snack right before bedtime to minimize nighttime reflux. E. Using a small pillow for sleeping Elevating the head and upper body during sleep can help prevent stomach acid from flowing into the esophagus. Using a small pillow for sleeping is a measure to reduce nighttime reflux and alleviate GERD symptoms.