Deciding on the Treatment
Deciding on the treatment requires knowledge about the remaining length of small bowel. This may require diagnostic testing, which usually begins with x-rays and/or an enteroscopy (using an endoscope, a thin, flexible tube with a light and a lens on the end) to examine the esophagus, stomach, and small bowel.
In the average adult, the minimal length of small bowel required so that some nutrient absorption can be anticipated is 4 feet. Usually this is counted as 4 feet of jejunum beyond the point where the duodenum ends (ligament of treitz). Parenteral nutrition is always required for remaining small bowel of less than 4 feet.
The length required for adequate fluid absorption and avoidance of dehydration will be influenced by whether or not the colon is intact. Parenteral nutrition is still required on many days for remaining bowel length of less than 10 feet.