Answer to Question 1
Because he was on a concentrated enteral feeding without adequate water.
Answer to Question 2
Most articles agree that psyhelium has a positive effect on lowering cholesterol, especially when included in a low-fat diet that includes plant sterols and other fibers that help lower cholesterol. Psyhelium seems to have a greater effect the higher the blood cholesterol is. The lower the blood cholesterol, the less the effect.