The first to appear in a cause of acute intestinal obstruction is

Symptoms of intestinal obstruction Symptoms of intestinal obstruction : Pain, vomiting, distension and constipation Pain is the first symptom encountered ; it occurs suddenly and is usually severe Pain in intestinal obstruction It is colicky in nature and is usually centered on the umbilicus(small bowel) or lower abdomen (large bowel) The pain coincides with increased peristaltic activity With increasing distension, the colicky pain is replaced by a mild constant diffuse pain The development of severe pain is indicative of the presence of strangulation Pain may not be a significant feature in post operative simple mechanical obstruction and does not usually occur in paralytic ileus Ref: Bailey and love 27th edition Pgno : 1285