How is pain originating from the small bowel usually characterized? What are common causes of small bowel pain?
Pain related to the small bowel is often felt in the midline or periumbilical region. Occasionally, it is felt in the flank or back. Classically, small intestine pain is worse after food intake. Depending on the underlying etiology, the severity can range from mild discomfort to severe acute pain. Intermittent “colicky” pain is often seen in the setting of small bowel obstruction (SBO), when the bowel wall smooth muscle contracts vigorously proximal to the obstruction. Mucosal inflammation or ulcerations may result in a vague soreness and ache. An inflammatory or neoplastic process that extends through to the serosa and adjacent parietal peritoneum will stimulate somatic pain pathways and manifest as more sharply localized pain at the site of the lesion.