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
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 its 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).

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.

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.


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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36 Comments on "Pancaking: A Headache for Ostomates since the 1800’s (w/ video)"
Colostomy on August 21, 2017. I use a small rubber syringe to wash my pouch when I empty it. I had the idea to use that syringe to add a little water to my pouch when I discover pancaking. About a teaspoon of water seems sufficient. It seems to work well. I’m up at 3 AM reading this site to validate my idea. I add the water at the ring as if “burping” the pouch. Thank you for a place to go.
I’m glad you found a method that works for you! Thanks for reading 😀
Hey Tom,
That would be a great question to ask on the Community Forums : https://www.veganostomy.ca/community/
I’d be happy to discuss this there!
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
Hi Debra,
I’m sorry to hear about your mom’s trouble.
I have an entire article that goes through possible reasons why a bag may not stick:
https://www.veganostomy.ca/ostomy-appliance-wont-stick/
It will likely take some investigative work to find the true reason, but I hope that the article gives you some direction in where to look.
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
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.
Good luck, Gail!!! That sounds promising!
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
That type of output is definitely the most frustrating. I address a few strategies on managing thick output in this article : https://www.veganostomy.ca/dealing-thick-ostomy-output/
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!
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.
I’d suggest you develop a working prototype, get a patent on it, and then start showcasing it :)
Sounds exciting!
Thanks. I’m going to give Coloplast, which has been the worst for me as far as pc goes, a call on Monday and see if they bite. I’m friendly with a rep over there.
Good luck! I would still suggest getting a patent so the idea doesn’t get stolen.
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
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!
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!
Thank you so much for your message – it means a lot to me.
I’m so glad that you have a loving partner who has seen you through all this! Best of luck to you!
Eric
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!
:) I hope your surgery went well! Enjoy!
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
Hey Donna! Potatoes are my weakness, and they do come out really thick. Eating and drinking helps me too.
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.
Hi @jenniferfussell:disqus . I have a “mini guide” to pouch liners that may offer you some insight: https://www.veganostomy.ca/mini-guide-to-ostomy-pouch-liners/
Good article. Luckily I haven’t had this problem as I have an ileostomy and I drink a lot of fluids.
Many colostomates have this problem, but I sometimes have it when my output is really thick (I do NOT drink enough!).