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Pancaking: A Headache for Ostomates since the 1800's (w/ video)  

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LK
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December 13, 2018 12:55 am  

Oh yes...I know this sound ridiculous, but I swish my food and fluids together in my tummy. It helps distribute the fluids better. Just keep your bottom more still then your chest and shoulders and and go quickly from left to right. I can hear mine when it swishes well. Lol. Seriously! I do this all the time. 

Linda


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Dona
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December 13, 2018 2:06 pm  

Hi danbh,

I addition to the things that the others have suggested to help with pancaking I would just add a couple of thoughts.

I used to have a lot of trouble with pancaking  ...also just at night. It is under control now, but I eliminated all the foods like nuts, crackers,dry kale ( better than one might think!) after 2PM. Basically any dry moisture absorbing or gritty type food.

I eat very little after lunch. Hard, but you get used to it. Keep drinking liquids or just eat sparsely of things with not much fiber ( low residue) foods.

Also, throughout the night, when I am just checking for gas etc, I push down any output that has collected on top of my stoma. Just use your fingers and shove it. Basically that just moves all of the material that will pancake. Once it is the bottom of the bag, it will be fine. 

Try those things for a few days and see if it helps.  Good luck. Let us know how you are doing.

Onset of severe Ulcerative Colitus Oct.2012. Subtotal colectomy with illiostomy July 2015; Peristomal hernia repair ( Sugarbaker, mesh, laparoscopic) May 2017.


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danbh
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December 13, 2018 7:25 pm  

Thank you Linda, I am on diabetes medication called "metformin" which is known to give loose stool, I wish it was loose, then it will not pancake.

I have a call to my Doctor, and will ask her if I can cut that medication for a day or two, and see what it does. So far I am eating salad, and chicken, and drink a lot, I even set myself a timer to remind me to drink. I tried pushing the lubricating deodorant up the bag, but that caused a leak from the bottom of the bag while I sleep.

Will wait to see what the Doctor says.

Thanks again

 


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dogtalkerer
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December 17, 2018 12:57 pm  

Dan,

with the first signs of pancaking, add very warm water to your bag, maybe 1 table spoon at first, and swish it around.  water shouldn't be hot to the touch.   this helps thin and also lubricate the inside of the bag.  contends should sink to bottom.

As far as having rabbit turds that drop to the bottom, I've had that on rare occasions, doesn't seem right for a human though.   mash potatoes will thin down my output. so will bean burritos. I've been pushing output down for years. I prefer thicker to thinnner.

sounds like you do need some exercises for your abdomen, a good discussion to have with a psychical therapist and surgeon together at same time.


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msf
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December 21, 2018 11:30 am  

Thanks for this article. i am learning lots on this site. I am a new ostomate with an ileostomy. I am a bit confused about something in this video. In the olio net I was given by the dietician at the hospital i was told that insoluble fiber is bad. In fact I was told that any food containing over 2 grams of fiber was bad. 'what is the reality? I love veggies and salad but now believe I can't likely ever eat salad/raw veg again?
Michael


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Shazzon
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December 22, 2018 10:44 am  

I have pancaking all the time . I have tried everything.the tissue piece in the bag helps and leaving a little air in the bag helps. I also use liners whenever I can and I find this helps a lot as it is easier to clean when my output is thick which is most of the time . I have had my stoma for nine months now and have learned more from your site than anywhere else thanks again for all you do .

 


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john68
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December 22, 2018 10:59 am  

Hi Shazzon, certain foods will keep the output thick, have you tried prune juice or other fruit juice to thin it out and keep things moving. Start with a little until you find what works. Some medication will cause thick output 

ileostomy 31st August 1994 for Crohns


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VeganOstomy
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December 22, 2018 11:07 am  
Posted by: msf

 the dietician at the hospital i was told that insoluble fiber is bad. In fact I was told that any food containing over 2 grams of fiber was bad. 'what is the reality?

Short answer : They are wrong  

Long answer : It depends on the context. They likely said to limit insoluble fiber because it increases the risk of blockages. However  this recommendation should only be temporary (usually the first 6 weeks) and it's consumption should be encouraged after that due to the numerous health benefits of the fiber itself and the foods it's found in. 

I would clarify it with them to see why they made this recommendation.

I love veggies and salad but now believe I can't likely ever eat salad/raw veg again?

This is why I dislike blanket warnings against eating fruits and vegetables with an ostomy; it leads to fear and confusion, and really is unnecessary for most ostomates  

Just your friendly neighborhood ostomate.

~ Crohn's Disease ¦ Ileostomy ~


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danbh
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December 22, 2018 11:28 am  

Thank you all for your ideas and solutions. I went yesterday to my Stoma nurse, and her idea was eating more oily stuff like Hummus, I love Hummus and will try it, but I don't think this would help much. She also put on me a different make pouch and wafer, the Coloplast Sensura Mio, which I am having trouble with the lock, she showed me how to lock it, but when I unlock it, it still does not open easy, and you have to really pull on it to get the pouch off. Also my Hollister unit give you the space to click the pouch on the wafer, where on the Coloplast you have to press down on your abdomen to click it in, and with only 3 weeks since my surgery, with sutures still fresh, it HURTS. I am going back to what I know, and have no trouble with - The Hollister. As for my skin around the stoma I was told to use the "Stoma powder" and the Cavilon barrier. The Stoma powder I thought was only to make sure the area is dry, not to heal a damaged skin, so I am going to my Pharmacist and see if she has anything that would not effect the barrier ability to stick to my skin. I think that these nurses are great, and do a job of looking and cleaning poop, with out blinking an eye, but they forget that we can not see what they see standing in front of us, not even in mirror when your eye sight is not great (due to diabetes). Time will tell, and hopefully things get better. I am not giving up.

Again, thanks to all who tried helping, and thank you Eric for a great website, and all your work. You are great.


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Tom Duerr
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December 23, 2018 8:17 am  

Everyone is different so you need to experiment with foods and with appliances. I have had an iliostomy for 9 years. This is what I have done to CURE pancaking. First, I don't know why anyone would use a 2 piece if they have pancaking issues. I have tried all the major manufacturers of 1 piece appliances over the past 9 years. For me it does not have much to do with what I eat. After trying multiple vendors I found Cymed had a product that would give me 3 days consistently. None of the others would last more than 1 day. Then in July of 2016 Cymed changed their wafer and adhesive(they had been getting their wafer material from Salts out of the UK). The new product would not last 12 hours. I contacted Salts(great people!) and they made only one product with this type of wafer (CDSS1325). They sent me samples. These lasted 3 to 6 days with NO pancaking. However, there are 2 things I am not happy about. One it is a convex wafer which tends to be a little bulky. Two, they do not have a distributor in the USA. I have to order them thru Canada(Argyle) and Medicare does not cover them. Cymed just went back to using Salts wafer material and I got 3 samples from them. They are not the same as the pre 2016 product. Leaked behind the wafer and somewhere on a seam....also they were almost impossible to empty and clean(see earlier threads on Cymed's quality control).

Pancaking is debilitating. I hope this solution works for you. Good luck!


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December1950
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December 23, 2018 10:33 am  

The powder can be used to help heal the skin around the stoma.  Sprinkle near the stoma, dust off excess and them dab with a skin barrier wipe. I use cavillon.  Let this dry for several seconds.  Yiu will see it begin to crust.  Then you apply your wafer.Do a youtube search...  Type in crusting around a stoma....a video will show you just how it's done.


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Douglas Seaburg
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January 6, 2019 5:06 pm  

Hi, Ileostomy almost 6 years now (ulcerative colitis). Been using the Mio 1 piece midi (10461) for 3 years. In the past 3 months I’ve had issues with pancaking. Never before. I use Eakin Seals normally but this past summer I began using the new Coloplast seals (much thinner and flexible than Eakin’s). Everything was fine until the last 3 months. I thought perhaps my skin was becoming to the new seal. So, I went back t Eakin seals. But I’m still experiencing the pancaking/output getting under the wafer.

I just found this discussion and your mention of the filter creating a vaccum immediately set off a light bulb in my head! I’ve been noticing that the inner bag has been wrapping VERY tight around my stoma. I don’t know exactly when I started but probably in the same time frame as the pancaking (3 or 4 months). Thing is...these filters never really worked in the 3 years I’ve been using this bag. But I always used to put stickers over it JUST in case the smell leaked out. I stopped using the stickers once I found Hollister m9 drops (100% kills all smell!!!). Anywho, on days when I’ve forgotten or been too lazy to add drops I’ve noticed a smell leaking out. Plus the vacuum seal. So....upon your suggestion above I put a sticker on the filter and blew some air into the bag with a blow dryer, to raise the bag off my stoma. Really hoping this is the fix. I really like this setup and until now had no problems. In fact I was getting 7 to 9 days between bag changes!!! I’ll report back in a few days to say if it worked or not.


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VeganOstomy
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January 7, 2019 11:37 am  

I hope that works, Douglas! The vacuum effect is really annoying.

I often get it, and just blowing air into the bag works great. Actually, I don't blow air into my bag - I just slightly open the two-piece flange, grab the front face of the bag and gently pull out on it so that air fills the bag that way. It's quick and works well. 

Just your friendly neighborhood ostomate.

~ Crohn's Disease ¦ Ileostomy ~


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LK
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January 8, 2019 4:49 am  

Hey Eric and All, yes allowing air into the bag is a good thing, and as far as the M9 goes, I will toot its praises. I use the Hollister 8331 with the filters and you are right they work poorly and only for about a day and a half. I like the plastic on this bag tho, it is quieter then on the bag without the filters unless my pharmacy had a lot of extras and they are old....Hmm? Maybe I should see if the comp. has changed the plastic on the bag without filters. However, I do find that the little it works, especially for the first day, it limits the amount my hands hurt after a bag change, by letting out the extra air for me. Most of it is being sure that the filter stays dry. Hardyhaha. But, this is where the Osto EZ Vent comes in too. Also, before bed when when having pancaking issues, I push the moisturizing liquid deodorant up and around the stoma and area, avoid the filter area by folding that part of the bag forward. I seem to always be aware of Rose working...so after I have had to help the contents along there way, I will try and take the sides of the bag where more deodorant may be and spread the liquid around there again. I have even taped it down that way. It too helps in conjunction with the other remedies. One more little thing, my Doctor lets me take Gas X and it has helped tremendously with the gas part of eating and guts. Not nearly the extent I used to get, and if it gets bad, there is little build up in my guts. 

Linda


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danbh
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January 11, 2019 1:08 pm  

Hello all, an update from my last post above...

I am back to my Hollister pouch & wafer (don't fix what's working is my motto).

My Stoma has now shrunk from size 1-3/4 to 1-1/8, and even better then that, it is now just at skin level (it was below originally) but I worry that it would become another parastomal hernia, it would be the third time,  I hope not. I am using now a cut to fit wafer (Hollister 11203 with filter, and so far it has done well for my skin around the Stoma, but pancaking is still an issue, and I still have to either drop it into the toilet, or push it down the bag. I ate a lot of Hummus (recommended by Stoma nurse as an oily substance) but as I wrote before, I did not believe it will work, and it did not.

If I find a way to kill the pancaking, I will post it right away, in the hope to help others, I also found a support group right here in town, meeting in the hospital where I had my surgeries, maybe I can find someone with an answer.

Have a great weekend everyone.

Dan

 


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VeganOstomy
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January 14, 2019 11:16 am  

Keep trying new things, danbh!

It would be amazing if some breakthrough in pancaking management comes along - but until then, all we can do is experiment to find something that works for us. 

 

Just your friendly neighborhood ostomate.

~ Crohn's Disease ¦ Ileostomy ~


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Lori Wooten
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March 13, 2019 3:09 pm  

I am a new ostomate and I am having a really hard time finding a bag/system that doesn't leak. My stoma seems to be recessed in my belly...so I think I'm not getting a good seal...I have had days that I have to change my entire bag/wafer 4 times a day, due to leaking. .that is reaking havoc on my skin, as you can image. I'm glad I found your videos...I'm learning a lot ...I'm still looking forward to getting my life back again. I had one week since I got out of the hospital that a bag stayed on for six days with no leaking!!! That was the best!!! Can't wait to master this thing so I can get back to my life!!


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VeganOstomy
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March 13, 2019 4:12 pm  
Posted by: Lori Wooten

I am a new ostomate and I am having a really hard time finding a bag/system that doesn't leak. My stoma seems to be recessed in my belly...so I think I'm not getting a good seal...

Hi Lori, 

You may have answered your own question :) Generally speaking, for flat or recessed stomas, the usual appliance you'll want to use is a convex one. If you are using a flat wafer, then you will likely have leaks in this situation. 

Are you able to speak with a nurse to talk about the option of trying a convex wafer? Every brand has them, but they often differ in the amount of convex they have and how firm the convexity is. You don't want something that's putting too much pressure on your skin as you may develop pressure sores, so it's important to try and speak with a stoma nurse before making any changes to convexity. 

Good luck!

 

Just your friendly neighborhood ostomate.

~ Crohn's Disease ¦ Ileostomy ~


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madrikh52
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March 14, 2019 11:32 pm  

Lori, I had a horrible time with this at first too. Here are a few things that made a world of difference. I now use a convex wafer- like Eric mentioned. Your bosomy nurse can usually provide you with a few different types/ brands to try. Also, before applying a new wafer, I dry my peristomal skin with a hair dryer on low heat. I also warm the wafer using the hair dryer. I now have to change my appliance every 3 days (max) because of ongoing skin issues, but the above steps made leaking almost non-existent for me. I hope this helps!

Marci


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