Most motility disturbances of the gut in the agenarian are secondary in nature. So far, only in the oesophagus an alteration of the motility due to age has been demonstrated. Difficulties in methodology are a major reason for our lack in knowledge about the bowel movements in old age. Most studies have been done in the oesophagus and distal colon since these organs are easily accessible for intubation. The majority of the motility disorders in old age are due to problems which accumulate when man gets older, like diabetes mellitus, cerebrovascular disease and intake of numerous drugs. These conditions may directly or indirectly affect the motor organic diseases, particularly carcinoma, which may mimick functional disorders, by a careful diagnostic work-up. The therapy should try in the old as in the young to cure the underlying pathomechanism.