Pain

Pain

Pain is the first symptom encountered; it occurs suddenly and is usually severe. It is colicky in nature and usually centred on the umbilicus (small bowel) or lower abdomen (large bowel) (see Chapter 63 ). The pain coincides with increased peristaltic activity . With increasing distension, the colicky pain is replaced by a more constant di ff use pain. If there is no ischaemia and the obstruction persists over several days, pain reduces and can disappear. lation, especially if the pain is continuous. Beware the patient whose pain is not controlled with intravenous opiates. Colicky pain may not be a significant feature in postoperative simple mechanical obstruction and colicky pain does not usually occur in paralytic ileus.