Bowel roller coaster. What to do?!

Given that he supposedly dealt with chronic bowel dysfunction I'd be suspicious that he is dosing with laxatives, is he handling his own medication (or perhaps check whether he has a hidden cache)?

My recommend is citrucel. Not metamucil which is also a psyllium fiber but is fermented and digested differently in the gut causing gas and bloating and an increase in problems. Citrucel stops both diarrhea and constipation and usually results in a formed stool a.m. daily. Must be consistent use. If no good after a month then that's not the answer. For some stool softeners work,but for others this allows for little sphincter control. It's worth a try. The constipation often goes to diarrhea and cramping. Increase fluid intake if your Father doesn't suffer from heart failure or other reasons he is unable to tolerate normal fluid intake. Seniors are dreadful about adequate fluid intake because they lose the drive to drink fluids. Exercise is key in bowel health. Increase that if able.
If none of these things work then yes, that gastrointestinal consult, but do know these problems are worse for those who suffered chronic issues earlier. Good luck.

Cwillie is right on the money. Discovered that my mom was using both laxatives and immodium. Ended up in the hospital. We realized that she could no longer handle her bowel health without strict oversight from her doctor.

Make sure he has no access to any bowel regulators and talk to his PCP. A gastro consult might be worth your while.

85 year old mother.

All laxatives, imodium & pepto bismal were removed from my mother's apartment. She was constantly abusing these products and almost got impacted several times.

Now she is in miralax per her primary every morning and her bowels have become regulated and stable.

"YOUR life is worthy of care. YOUR life is not as important as your mother's, it's MORE important. We forget this very quickly when we care for elderly parents. Our lives are more important than theirs because it is YOUR life. The life you have is the only one you get. I will fight this point all day long and don't care who thinks I'm selfish, etc."

This was in a previous post by you.

"The problem is he has made his bowels my responsibility just by virtue of not being able to control these issues himself anymore."

So he was responsible for "bowel abuse" when you were a child (didn't your pediatrician or family doctor have any input?), and now he expects you to be his Bowel Master?

I am curious -- do you have siblings? How long have you have you been the elder caregiver? (I see you ended up placing your mother in MC.) WHY are you the elder caregiver? ARE you putting yourself first?

Lots of underlying issues can cause vacating issues. Seeing a gastro (GI) MD -- a geriatric one -- and have a work up done. There could be underlying medical or Rx issues to be addressed. My 85 YO mom was having similar issues in her nursing home. With a GI MD, a dietician and some Rx changes they got it worked out. She was on IV antibiotics for 8 weeks following a blood infection; and that triggered a host of GI issues. As others have said, poor fluid intake as well as poor diet AND lack of exercise (just walking) all contribute to these issues. My mom's favorite foods are rice, pasta, bread, crackers, chips, cookies, etc all which become "like concrete" in the GI system. A better diet, more water, a stool softener, probiotics and w/Rx changes things are better now, but it took 5 months to work through it. The dietician was very helpful. They also switched her to "depends" so accidents are less of a mess, plastic sheeting under actual sheets and placement of a potty chair right next to the bed for emergencies as she too cannot get to the bathroom on time, every time with her near inability to walk at this point (uses a walker for short 10-15 feet distances or else it is a wheelchair). The potty chair right there, next to the bed -- even if not used -- also helps keep things calm, no rush or panic -- much less falling when rushing -- to get to the bathroom (which is only about 15 feet away, but still very hard to get there in time for many elderly folks). If the bedroom is carpeted, just put a secure rubber pad under the potty chair (that that will not slip) so if the chair is "missed" clean up is easier.

I was surprised to learn that diarrhea can be caused by constipation or blockage so there may be more going especially if he has been manipulating his system most of his life. I would start by getting him a referral to a gastroenterologist. This should feed right into his obsession and they can talk bowl health at the very least but your dad may be more inclined to follow the specialists advice too. If you are able try messaging the doctor first to give them some background on your dads life obsession and when this started becoming a bigger problem for you, they should have some suggestions at least if they don’t find any cause that can be treated. After that if speed is a big part of the problem how about a commode? It still has to be cleaned obviously but might be easier than missing the bathroom. Disposable underwear is an option too but still body cleaning that needs to be done so if he is capable maybe one of those bidets that can be attached to the toilet to help him clean up on his own?

My 88 yr old father takes fiber every day and it has regulated him. He cannot take any type of stool softener or laxative without having explosive diarrhea. The powdered fiber dissolved in water does the trick. And the good news is that it helps with both extremes, constipation and diarrhea, and it is a very mild fix

While you and your father are working out a solution, consider removable top liner pads especially designed with a broader back section. They adhere to the underwear or pull-up and can easily be removed before inserting once the adhesive is gently lessened by rubbing against cloth. Bowel irregularities are so common and they require a trial and error process to get a balance that is easily disrupted.

Dear Exhausted One; I feel your pain as I have been dealing with this for the past 18 month or so. My mother is on chronic pain meds so she is given medication to alleviate constipation. But, the result is often complete diarrhea beyond what anyone can understand unless you have lived it! And, helping clean up Poo of your parents is more than most of us can handle. I would most definitely take him to a gastroenterologist, he/she can assist with meds that will at least assist with the frequency of the episodes. And, other than that, trial and error was the best way to improve my mothers bowel troubles......working out what seems to be best for HER in terms of the meds was what I ultimately did. Thankfully, her doctor agreed with me that since I am the one caring for her, I knew better than he did. So, she takes one to two pills a week, versus one per day and it seems to give this best result. I'm sorry your are going through this, it is very tough!

Since your father has had long-standing issues with his bowels, I would suggest starting the a trip to a gastroenterologist in 2 weeks. Start keeping a log of your father's diet (with times, food/drink eaten and amounts) and his bowel pattern (times, how much, consistency of his poor, color of his poop). The doctor might also want a stool sample - ask so you can have one when you go for his visit.

Sorry he created problems for the rest of the family with his obsession.

My Mom ( 99) has a long history of gastro issues ranging from
crohns, IBS, ulcers and a history of diarrhea, chronic stomach pain.
She only has a third of her stomach from 2 ulcer surgeries in 1960’s & 70’s.
After finding an attentive gastroenterologist, we have her symptoms under control. Align( pro biotic), Budesonide (steroid),
mesalamine (crohns) etc, etc.
Too risky for colonoscopy or endoscopy. besides, what would we do with the information at 99….. ergo the medication that has stabilized the symptoms.
Try to find a highly qualified gastroenterologist.

My mum used to use laxatives all the time in her 60’s, early 70’s.. she was addicted to the “empty all” feeling! Let it all out! I’m so grateful she has forgotten all about them as I’m sure I’d be cleaning up a lot of poop these days considering she struggles with getting to the toilet on time to pee. Funnily enough now that she no longer has them, her system has regulated and she has a bowel movement almost every day. I’m conscious that her stools are probably a little on the hard side but as a carer and her wiping ability, I’m kind of glad and I’m worried about adding something to soften things. Instead I try concentrating on what she eats.

Check out his medicine cabinet to see if he's using laxatives. More than likely if he pushed those for his kids when younger, he's using them now and probably where the loose stool comes from. He focuses on not pooping, takes something and it works too much.

He has a lifetime of focus on something he thought should happen every - single - day! The less he moves (now) the slower the gut gets. If he takes any kind of pain med (and some others) - those slow the gut even more.

There are natural thing for him to try first. Such as flax in cereals/breads. There is ground flax you can add to foods. Papaya (if he will eat it) is great for causing a BM. Lemon juice in hot water each morning helps many people.

The meds that will probably be described for constipation by a doctor can be very harsh. Linzess is one and Trulance is another. Linzess is a capsule and even the smallest dose can create a blow out. The Trulance is a tablet - you can cut that one into 4 pieces and start off with smaller amount.

I would suggest starting with bran cereals, breads with flax, and the papaya. Those worked quite well for my parent. There is a bread called Ezekiel with flax that is great -- found in the frozen food. Keep in the freezer and take out a few slices at a time for refrigerator to keep it fresh.

Also… we are keeping a food diary
and dairy is one of the culprits. Turns out Mom is lactose intolerant

could be gluten too but start with elimination of dairy first.

Time for a gastroenterologist to take a look. Literally.

My SIL is a GI doc and he says a lot of older people are bowel obsessed, he doesn't know WHY, my own dad was and I remember distinctly living in a home with 5 kids and ONE bathroom.

There are medications to help make dad more 'regular'--and a GI will do a thorough checkup to see if dad has food issues that are causing this.

At his age he probably will not be subject to a colonoscopy, but a sigmoidoscopy may be in order. I'm not a GI, but helped SIL study enough I sometimes feel I could do a full GI workup.

Personally, I don't know which is worse, constipation or diarrhea. Both are miserable and a mess to deal with.

If you can be the one who controls what dad eats and such--you may find that he's over dosing on laxatives and then diarrhea meds.

You can start with a medical checkup. Two you can find a caretaker to deal with cleaning up the sh*t - I know I could not handle this at all. Third, you make arrangements to place him. I don't think everyone can be a caretaker and there are some things almost no one can do. You have no choice but to act to do something about this as it will get worse.

Would a bedside commode help? Maybe situate it near him with paper, wipes, hand sanitizer, trash can, etc. The liner would need to be thrown away immediately of course, but if he can get to it in time, that would sure be better than cleaning up an unfettered mess.

You father has quite possibly destroyed his own bowel regulation by years of abusing it. However there is an issue where the bowel is partly obstructed by hard feces, and the body copes by liquifying enough matter to squirt past the obstruction. So it comes across as constipation followed by diarrhoea.

The chances are that your father has various pills, potions and suppositories hidden away, and is still on the merry-go-round. People don’t give up a life-long obsession easily.

You may or may not know that the US culture was (at least in the past) notorious for this obsession. Long ago my first husband worked in London with a visiting young US couple. Judy’s mother asked about her bowels in every letter. When Judy wrote back saying that she was fine and London chemists didn’t stock suppositories, her mother sent her them in the post! Huge joke at the office!

ExhaustedOne: Your father needs to see his gastroenterologist as soon as is possible.

See his PCP to organize a colonoscopy or gastroenterologist to rule out physical problems. A colonoscopy could be in order due to irregular bowel patterns. Other reasons for constipation includes not drinking enough water, inactivity, and fiber-poor diet. If the colonoscopy comes out negative, bowel obsession can be the result of psychological reasons such as strict toilet training. If he is laxative dependent, this is yet another issue that will need treatment.

If he eats sugarless candies that can cause terrible diarrhea due to the indigestible sugar will accumulate water in the bowel turning into explosive diarrhea.

My dads 98 and has occasional issues with this. His geriatric doctor suggested Metamucil. My dad eats a package of the cookies each day. It has helped to bulk him up.

Gastroenterologist

PCP update: take half doses of his Mirolax every day instead of one. I'm not sure this is the answer but he does vacillate often between constipation and diarrhea. He had a bowel obstruction years ago and was hospitalized for it and he will do anything to avoid that again so he's open to the Mirolax as opposed to fiber.

Thanks for all your suggestions, I really appreciate it!!!

Some additional tools for this situation: adult incontinence underwear (call them "astronaut pants" if he resists - astronauts have to wear them in the rocket ships when they are not able to move around). Also, put disposable pads under him where he sits and sleeps. Get gentle wipes for cleanup. Good luck. this happens with many older people. Have a plan B if his care gets to be too much for you. You can get aides in to help your work, or he can look at senior assisted living residences.

My husband, at 91 and with IBS plus Parkinson's, has some issues. He sees a gastroenterologist and that specialist has been helpful with what seems to me quite the regimen, and it seems to work for him...but be advised that there is a lot of guess work and trial and error to get to a comfortable place. Be reminded that each person's system is different. He takes Optifiber every morning, Miralax on Monday, Wednesdays, and Fridays, stool softeners in am/pm, and 2 senna tablets at night. He must stay hydrated, and he must move around as much as he can.

Good luck with a difficult problem but one that can be managed, hopefully, better than it is being managed now.

I would recommend, that if you have not already done so, that you get your father medically evaluated so you have some idea of what is really causing his issues. For example, if there is a co-morbidity or underlying disease that can be addressed or whether this is someone who is "wearing out" from age. The course of action might be different depending on the answers to that.

I understand where you're coming from. I too am the designated Poop Master by virtue of my mother having issues and isn't comfortable complaining about her health to anyone else. Normally I just ignore her and walk away.
You could take your father to a gastro specialist it couldn't hurt. If you've done all the special diets and everything else, there's probably not much they will do for you. I've been an in-home caregiver for a very long time. I had to get out of it because I just couldn't take the piss and sh*t anymore. I've had almost 25 years of it though. This being said, there have been many families over the years who I worked for that had their elderly living with them. For the most part they were wonderful and caring people who really wanted to do right by their elderly and tried their best to. Many of those elders ended up being placed in care because the family just couldn't deal with the incontinence anymore. They couldn't take one more day of living in a house that stank to the high heavens 24 hours a day. Or furniture and carpets stained with piss and crap. Or one more stinking load of bedding or clothing soiled with incontinence. None of these people were bad people. They had to place their elderly loved ones though. It won't make you a bad person if place your father because of the incontinence.
I remember a client from years ago. She lived with her daughter who I became very good friends with and still am. I came into work one day and the stink hit me in the face the minute I walked in. This was a daily thing. There was her elderly mother in the recliner (she slept in the chair). Everything was pissed and crapped through. It was all over her, the chair, the floor. Her daughter had been begging her for two hours to please get up and she'd help her wash up. The mother was stubborn and refused. The choice was clean up or leave in an ambulance. She didn't think we'd do it, but we called. My friend was beside herself.
I helped her find a decent care home for her mother to be placed in. It meant that I lost that job, but it was the right thing to do.
I think it might be the right thing for you to do for your father too.

My mom has had the roller coaster too… sits on the toilet forever, became the women on the toilet at AL … uggg..from constipation to chronic diarrhea… she says she has to have a movement everyday… 😳where does this behavior come from…

she decided at memory care she wanted cheerios for lunch , diarrhea went away … simple diet change

go to a Gastro doc…

My GI doc prescribed about a teaspoon of Miralax each day and two fiber pills. Miralax helps things move, and the fiber pills keep things bulkier. Miralax alone can cause what I call "mud." (Sorry for the image.)

Definitely consult a GI doctor, though, because yes, a PCP is useless.