Do people with paralytic ileus have a lot of pain?

Highly variable.: Paralytic ileus describes dysfunction of the intestinal tract where the bowels "shut off" causing bloating, nausea+/-vomiting, and cramping pain. Ileus is always secondary to an underlying process in the abdomen (infection, intestinal surgery); therefore, there may be pain associated with the primary process, as well. Once the primary process is treated, intestinal function returns to normal.

No: Usually not since it tends to be a condition the occurs after the person had abdominal surgery. It just means that the intestines are not working. If the person tries to eat may vomit and get cramps and bloating. Intestinal obstruction should not be confused with this and it is treated differently. That can be painful.