This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: G.I.T, Subject name: Surgery
The first to appear in a cause of acute intestinal obstruction? 
Select and explain. 
A. Constipation, B. Colicky pain, C. Vomiting, D. Distension
B: Colicky pain
Answer: B: Colicky pain 
Explanation: Symptoms of Intestinal Obstruction: Symptoms of intestinal obstruction : Pain, vomiting, distensionn 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 postoperative simple mechanical obstruction and doesnot usually occur in paralytic ileus Ref: Bailey 27th edition Pgno: 1285