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.
Table of Contents
Video
By playing the above video you agree to YouTube's Terms and Conditions and Privacy Policy
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?
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?
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
Hey there homesheba and…I have not met you yet…but am glad you are here. I too am just 60 and had a great hubby who unfortunately died of pancreatic cancer just before our thirtieth anniversary. I offered him the road away from me many times because of my health, he always looked at me and said No…that is not the way do things and you know better! We loved each other dearly and I miss him horribly. When I think of the amount of appointment’s and hospitals and surgery and bills I have had, it is crazy. Living in B.C. we have a good medical plan, but I have discovered there are meds and things just not covered. I have not one right to complain. My doctor fights for me when I need special authorizations and I love him for that. My man died just shortly after I had my ostomy surgery. For a while I truly thought that the stress of me had killed him. But knowing cancer is high in his family, I knew better once I had thought it over.. I live in a small town away from my family, my two kids and grands are here, but I had no one to talk to about these issues, if had I know they would not have understood, I decided to see what was out there, if there was support anywhere. I am still learning about computers and just figured out spell check! so it has been an interesting journey for sure. It has been a hard life as I have several other health issues. My man was every bit of support I ever had. I do believe it is by the grace of God that I am even alive today. Especially after the year I was in hospital before the ileostomy. It was exhausting to no end, and took a long time to recover from. The lights always on, noise, someone always touching you clinically for one thing or another. Not enough fat on my eye lids to make a dark room when I closed them. No one really understood, no one to really talk to when he, had to go home to work after his weekly four hour visit. Praying he would get home okay. Thank heaven for telephones! Five hours away from family. It was hard. But I was determined to not let it get the best of me in any way shape or form. I was going to move on come hell or high water. I was going to survive. What shocked me was that I did! With the issues of further gut pain and being told another weird diagnoses of “pseudo blockages" I felt desperate. I had had such gut wrenching pain that …well, you likely know if you have had blockages or worse. But something like pseudo blockages and having to sort out what it could be called as not one doctor wanted to name it. Then I found rare bowel diseases. I brought this up with my doctors about something called Ogilvies Syndrome, I thought I had written the page. My GP said yes, that sure sounds like it. I can not say that is what I have as I do not self diagnose, but I am aware of what is an emergency enough to know when to go to the hospital, so I try to get thru what I can at home. Narcotics are a part of my life right down to Fentanyl, just do not give me a shot of the stuff, it does nothing for me, good old morphine is what works for me. I do not have an addictive personality, and my doctors are aware I have great respect for medications. I never abuse there orders either. Anyways, in a way we are all our own advocate, but having this sight has had me talking for probably the first time in my life about issues that were never talked about in my parents home. Jennifer, your a tough gal. Hang in there and I would say to any newbie, read what ever you can set your eyes on. Watch every single video Eric has. Take one day at a time. Things do get better. Just hang in there all the time. Look after yourself well and if you need to talk about anything or get ideas, this is a great place to be and then some.Linda
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!).
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.
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.