The gastrointestinal transit can be disturbed in different situations by increased or decreased motility patterns. Pharmacological treatment of gastrointestinal motility disorders is intended to inhibit or stimulate motility. Prokinetic agents as metoclopramide, domperidone, erythromycin or tegaserod are used in clinical settings. We discuss their use in functional dyspepsia and gastroparesis. Management of chronic constipation consists of increasing fluid and dietary fiber intake and increasing physical activity. Fiber, lubricants, osmotic and stimulative laxatives increase stool frequency and improve symptoms of constipation. Treatment of irritable bowel syndrome (IBS) should focuses on the specific gastrointestinal complaints. In constipation predominant IBS fiber and isoosmotic laxatives are used first line. Tegaserod has an advantage over placebo in constipation-predominant IBS. Pain can be treated with antispasmodic agents and tricyclic antidepressants in low doses. The diarrhea-predominant IBS responds well to a loperamide treatment.