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

Ostomy Pancaking
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I love pancakes, but I don’t like pancaking! In the world of ostomies, pancaking can be a frustrating, challenging and sometimes a messy ordeal. Pancaking applies mostly to colostomates, although some ileostomates with thick stool might experience this too.

Video

https://youtu.be/3EIC4zrUups

First, a quick definition:

“Pancaking” is a word that an ostomate might use to describe when their stoma output stays on the top part of the pouch and/or collects around the stoma.

Without anyplace for the stool to go (stubborn stool!), it often forces it’s way under the wafer or muscles through to push the pouch off. Obviously, nobody wants to deal with leaks in this way, so it’s important to identify the cause, and correct the problem.

I’m my experience with thick ileostomy output, pancaking has only caused leaks when it happens overnight; when it happens during the day, I can usually intervene before things go south.

Here are a few possible causes and some things to try:

Thick stool

There are a few ways of dealing with thick stool; I wrote an entire article about it HERE, but these tips are specific to help prevent pancaking.

Lubricate the inside of your pouch. This can be done using a lubricating gel or liquid designed specifically for ostomy pouches, or using DIY methods like olive oil or cooking spray. The idea is to coat the inside of your pouch so that stool can slide down to a happy place at the bottom of your pouch. Lubricants need to be reapplied whenever the pouch is emptied, but it’s important that you Lubricate up to the top of the pouch (if possible).

Coloplast Lubricating Deodorant
Coloplast Lubricating Deodorant

 

Drink more liquids. Adding more water or other fluids to your diet will help to soften stool. Some people might try beverages known to loosen output like: prune, apple or grape juice; other options like coffee or even soda could create the same effect too.

Increase fiber intake, but focus on insoluble fiber. This shouldn’t be a problem if you’re eating a lot of plant foods, but increasing insoluble fiber will move things along and can prevent stool from becoming dry, hard and difficult to pass. You’d typically want to focus on whole grains, vegetables and produce with skins. Use caution with high-fiber intake if you’re fresh out of surgery.

Vegan chili pot
Vegan chili pot (lots of insoluble fiber in those beans & broccoli)

Some ostomates are told to take laxatives by their doctor. I would personally avoid this option as laxatives can create other problems down the road. Check with your stoma nurse or doctor if you feel that laxatives are needed.

Check your filter

Believe it or not, some pouch filers work too well, and they remove air from the bag while creating a vacuum at the same time. If this is the case for you, cover the outer filter on your pouch using a sticker (they often come included with your pouches). Some brands, like Hollister, don’t include these stickers, so you’ll have to improvise and use tape or something similar.

Coloplast Sensura Mio filter stickers
These stickers go on your filter.
Coloplast Sensura Mio filter
Be sure to put stickers on the OUTSIDE of your filter so you can remove it later.

If it turns out that your filter is being too aggressive, keep using the sticker, and periodically remove it when your pouch begins to fill with gas. If this is too much trouble, you might want to try other pouch systems to see if another style of filter weekends l works better.

You can also try blowing a bit of air into the pouch when you empty or change it; this bit of air will counter the vacuum effect and will help regardless if your pouch has a filter on it or not.

Stuff it!

I’ve heard of some ostomates putting a bit of wet tissue/toilet paper inside their pouch to prevent the pouch from being too flat. This method is similar to blowing air in your pouch, although it may not prevent the vacuum effect caused by a filter. The downside is that it’s more inconvenient to use this method.

Let’s get physical!

Sometimes you have to manually move pancaked stool down in order to avoid problems from developing. Don’t be afraid to push, shove and squeeze that stool down to the bottom of your pouch. This may be necessary if you’re wearing an ostomy wrap or tight-fitting clothes.

Additional Tips

  • If you’re covering your filter, uncover it at night so you don’t have problems with ballooning (when your pouch is too full of gas).
  • Rinse the inside of your pouch before changing it, as it’ll help remove any stool that might be stuck around your stoma.
  • Rinsing can also help to empty your pouch during regular toilet visits.
  • Some oil lubricants may reduce your wear time, so use a commercial ostomy lubricant to minimize that risk.
  • Experiment with different ostomy systems to see if another brand or style reduces pancaking for you. This may be necessary if the filter on your current pouch is too troublesome.

QUESTION : What do you do to prevent or deal with pancaking?

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35 thoughts on “Pancaking: A Headache for Ostomates since the 1800’s (w/ video)

  1. This post is for Robin who has the odor problem. I tried everything. Then I discovered chlorophyll. I take 2 tablets per day and it reduces the odor to almost nothing. And chlorophyll is an excellent antioxidant so it’s really good for you. The principle here is to help solve the problem internally. Bag deodorants help but they only attempt to mask odor. Other pluses to chlorophyll is that it helps freshen your breath and it will actually reduce armpit odor. It’s very inexpensive. About $8 per 100 tabs on Amazon.

    Good luck and let us know if it works for you.

  2. I have had an iliostomy for 8 years. It took many months to find an appliance that would last for more than 12 hours(I tried every major brand). It was a Cy-Med 1 piece. I wore this for about 5 years and consistently got 3 days out of them. All of a sudden they started pancaking and leaking after only a few hours. After investigating, I found out that they changed their formula of their wafer. They started using a more advanced extended wear hydocolloid. I called every warehouse in the USA to get all Cy-Med’s product manufactured before they started using their new wafer. This supply lasted me another year while I started to find a replacement. Salts from the UK has a product that works but it is convex and creates other issues(edges curl). Long story short, I know how to put on an appliance but something in my skin just does not do well with these new hydocolloids. I have talked with multiple ostomy nurses from hospitals and appliance manufacturers. Has anyone had a similar problem and found a workable solution?

  3. My Mom is 91 years old and had to have a colostomy is May, ever since then ,her appliance has not stayed on for more than 2 days. She has pancaking all the time,her wafer comes off sometimes 4 times a day, her output gets all over her clothes and her. Very expensive and frustrating, any suggestions to help us out?

    ER

  4. I’m 4 weeks out of surgery. My dr prescribed iron pills. These make my output smell sooo bad and dark and pasty the smell is what I hate the most. I get paranoid around ppl and I know ppl can smell it. I’ve tried the mouthwash and baking soda and the iron seems to make the bag weaker. I’ve cut back to 1 pill every couple days so that it is close to changing day.
    I also want to say thank you! When I was released from hospital they gave me NO directions at all and I have had to rely on internet for answers to everything. It took me 3 weeks to get supplies. (I had to make bags last 7 days) so for us frustrated newbies ur website is so relieving and helpful. Please keep it up.

    • Hey, Robin.

      Yeah, iron pills do crazy things to our output! Are you taking it with food? That may help a little, but consider getting an ostomy pouch deodorant to see if it also helps.

      Wishing you all the best!

      Eric

  5. I have had my colonoscopy for 6 months and have always had a problem with pancaking, thick stools around the stoma and leaking. Last night I read some of your articles, changed my pouch, and put some oil inside the pouch. Today I had an almost full pouch with no pancaking and no leakage! I know it may be too early to know if this is permanent, but I am so encouraged and excited!!!! Thank you so very, very much.

  6. Eric, would you talk a little about clingy sticky iliestomy output. Still dealing with it. You said you had it before. How you manage it. Wits end here. An still waiting for ostomy Nurse to call me. You think grape juice would help? Thanks. lia

  7. Which bag is more recommended for high loose output? My stoma is flat and new. I was the queen of blow outs in my month long hospital and rehab stay. Nothing new to me for 3-5 blow outs in one day until one sticks. Using wafers with eakin rings along with paste. One and two piece bags I’ve tried. Can’t figure out the difference. I do like the filter bags for sure. My skin is very sensitive and I’ve dealt with erosion already. That was awful.
    One company sent me a huge supply of the MIO bags and they just look small compared to the other bags I’ve been using. I had called for samples only and they sent me a huge supply to charge my insurance with approx 60 of these bags that I’ve never tried. Should I send the smaller bags back and ask for samples like the original conversation? They included plenty of each product to be used in the monstrous box. Not the little trial is asked for.
    I’m just lost. I’ve been told I need a convex for leaks due to my ileostomy and liquid output.

    What seems to work for others here. I’m so confused and lost. …
    Thank you in advance, Jennifer

    • Hi @jenniferfussell:disqus .

      I’d recomment taking a look at this article to help you better manage your loose output: https://www.veganostomy.ca/dealing-liquid-ostomy-output/

      When it comes to appliances, generally speaking it won’t matter if it’s a one or two piece, but you might do better with “extended wear” wafers. The barrier rings can help, but I’d try just the wafer on its own and move from there if you need to (sometimes the rings erode quickly, as you’ve experienced…. try different brands).

      Good luck!

  8. My theory is that pancaking is caused by a design flaw in all bags and I have a couple of ideas of how to rectify it but don’t know who in the companies to reach out to with them.

  9. I am a relatively new ostomate having had my surgery 6 weeks ago. I am using the Sensura Mio 2 piece bag with a convex wafer. I use the sticker and the deodorant gel and I still experience pancaking. I have used other brands (Hollister, Convatec), flat, convex. Changed my diet as much as I can at this point. Not sure what else to do. Any suggestions from experienced ostomates are welcome!

    • Hi Wendy,

      I would imagine that’s pretty frustrating! When you put the sticker on the filter, do you blow a bit of air into the bag, or do you put some wet toilet paper into the bag? You need to make sure that there’s some air in there to separate the walls of the pouch, or else it’ll create a vacuum.

      Also, do you have an ileostomy or colostomy? How thick is your output and is it like that all the time? Do you ever experience less pancaking or is it all the time?

      Regards, Eric

      • Eric,

        Thanks for your quick reply! I have a colostomy. I had my sigmoid colon removed and understand that my output should be fairly “solid”…but it isn’t. It is the consistency of whipped potato all the time. I have had the pancaking problem since day one. It has caused skin irritation and leaks. I don’t think I have worn a bag for more than 2 days, if I’m lucky. The output pancakes and pushes under the wafer even with an Eakin ring. The Mio 2 piece has been the best and longest lasting so far.

        I have tried blowing air into the bag but never tried the wet TP. I will give that a shot.

        Thanks,

        Wendy

        • I’m surprised that you find the Mio works best for you; I experienced more pancaking with the Mio because of the large filter.

          But it often takes some experimentation to find a combination or technique that works for you.

          Wishing you all the best!

  10. Thanks for answering several questions I had about baby oil use, stuffing in some TP and using stool deodorant drops. You are a great help!

  11. I’m 61 years old and have had an ileostomy since I was 27 due to crohns. I Have gone through several major surgeries as basically i believe I was a test case for some doctors. Many times there just wasn’t the knowledge or medications that could have been utilized. but the Lord kept me alive and now my major problem is scar tissue adhesions and blockages. I am so thankful that you have this site to help so many people! Much of what you discuss I have learned thru trial and error throughout the years, truly what you do is so important for many and I just wanted to thank you so much because I know how terrible it was for me to basically have no one to talk to about the scary things that happened while trying to learn to live with the ostomy. I have been married 43 years now to a man who meant the vows he took with me for “sickness and Heath, better or worst’, and even tho there were many many trying times and loads of doctor , hospital , etc. bills, life has given me much joy and perhaps without what I have gone through I would not have appreciated things as much as I do. .. Just a thought?

  12. I have just found this website and I am wrapped. I am a newbie as I had my surgery in June. This site is going to be so helpful, thankyou!

  13. This is a great article. My son has an illiostomy “Crohn’s” and only has problems with french fries and tater tots since they don’t break down very well ( come out like they go in). He has to “chew chew chew swallow drink water” with each fry or else they all come out at once and cause his bag to push right off. He is 16 and had his first surgery 3.5 years ago. We learn as we go. Thanks

  14. Always an issue for me. I use colomajic disposable liners with a 2 piece system. simply remove the disposable liner and replace. They are less than 0.05 cents a bag in Canada and they extend the time range of my bags

    • I’m new to an ileostomy. Please explain about disposable liners. Seems like less mess to deal with. Plus while out and about seems to be less burden. Which bags are they made for? I’m fresh out of surgery and the hospital since last week and surgery was on 3/25/17. All of this is so overwhelming. Ruptured appendix and bowel blockage with 24 window of losing my life got me a my very own stoma. Bleh. Life for me is blessed but I’m just learning.

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