Bowel roller coaster. What to do?!

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!

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.

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)?

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.

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.

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?

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.

"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?

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.