Abdominal symptoms due to motility disturbances of the lower gut consist mainly of discrete pain episodes or a long-lasting feeling of fullness and distension. Long-term recording has shown that these symptoms are partly related to propagated contraction waves of the colon which induce mass movement of colonic contents. Patients probably experience that normal contractile activity is unpleasant or painful and apparently have a decreased threshold of perception. Also, peculiar contraction patterns of the small intestine ('clustered contractions') have been related to pain episodes. Fullness and distension are characteristic for slow transit constipation, but also occur in disordered defecation. Future studies on treatment will have to concentrate on pathophysiologically defined subgroups.