Answer to Question 1
Mr. Page can be advanced to a diet consisting of the following: 5-6 small meals. 50 complex carbohydrates with avoidance of simple sugars and FODMAPS such as fructose, high fructose corn syrup and sugar alcohols. Fat should be restricted to <30 of total calories. Protein should be 20-30 of total calories with an emphasis on high biological food choices. Soluble fiber should be emphasized with approximately 5-10 g/day. Limit high oxalate foods.
The hyperosmolality of clear liquids, which might be typically ordered, may actually increase stool output.
Any food that causes an increase in diarrhea or pain should be avoided and tried at a later date.
The use of a lactose-free liquid supplement would be a good choice to increase his overall intake.
When Mr. Page can consume 60 of his requirements by mouth, the parenteral nutrition can be weaned.
Answer to Question 2
Sepsis: an immunosuppressive process that prevents an adequate response to infection
SIRS (systemic inflammatory response syndrome): a clinical response to a non-specific insult such as trauma, ischemia, hemorrhage, burns, infection and pancreatitis
Unlike sepsis, SIRS is not always related to infection.