Paralytic ileus is the temporary cessation of bowel motility after abdominal surgery. Return of bowel function is confirmed by:

1. Passage of flatus (gas) — earliest and most reliable sign of return of peristalsis
2. Bowel sounds (return in small bowel first, usually 24–48 hrs; large bowel 48–72 hrs)
3. Passage of stool

Assessment sequence for bowel function return:

• Auscultate for bowel sounds (all four quadrants, 2 minutes each)
• Ask patient about passage of gas (flatus)
• Advance diet only after confirmed peristalsis (clear liquids → soft → regular)

Failure of bowel function to return may indicate mechanical obstruction, which requires surgical intervention — a critical distinction for Charge/Head Nurses.