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.
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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?
Hello-Had surprise surgery 5 months ago for
Diverticuloses. Have seen several of your videos and appreciate them. I have pancaking and do not like it. Know I need to drink more water and working on two large 24 oz a day plus a third glass. Also drink some milk after peeing middle of night several times!
After dealing with hospital and home health I found out about lubricants on my own and use Adapt deodorant and lubricant and it helps but really does not do a good job of moving things along or lessening the odor. I eat onions and some garlic and not giving those up. Kept thinking something has to be better! Maybe through you or someone online learned about Revels It’s in the Bag and requested a sample. Went to site and asked questions and of course no reply and no product yet but only been 3-4 days. Does their product actually improve the issues? I hope so. Know you know about this so would love your reply. I use Hollister one piece and Eakin Cohesive seal O-ring, think and thin seal, may have used ring by Hollister too. The seal breaks down and makes a bit of a mess to clean up too. Then I sometimes get no waste in bag for 12-20 hours and feel and know backup. All I eat breaks down except carrots. Will you share with me brands you use? If you cannot for advertising or contact issues I understand. Does ring brand make any difference. We attach it to bag and then place on belly.
Have you been dealing with colon issues for some time? Do find online discussions and videos most useful. Not too skillful on the internet. Everyone says to talk to your stoma nurse but find they are not really too helpful. Were great while in hospital and will answer questions on phone in delayed fashion but … I can make an appointment but that might not be when I have an issue. Have called several nurse hotlines and they are helpful. Fortunately doing OK so not too much to complain about. Hope It’s in the bag helps!
Thank you for your time reading my note and getting back to me. Barbara Dean in Athens, GA Go Dawgs!
Hi Barbara,
Thank you for post.
I have not heard of the brand Revel, nor their lubricant, but now I’m interested!
I’d keep waiting for the samples, since that can sometimes take some time, even with other companies.
If you could post back here after trying it, I’d love to know your experience!
I had bowel issues from the mid 2000’s, and I didn’t really connect with others online until I had my ostomy surgery. The internet can be helpful when finding information, but with the rise of AI generated content and social media manipulation, It’s lost much of its lustre for me.
I hope that your health continues to improve, and look forward to an update 😀
Barbara, so many of us here suffer pancaking problems. It goes with the territory, I guess. I haven’t found a solution, but the way I deal with it is a bit different. I have a colostomy, so my output is fairly solid. I wear a 2 piece system; when I have output, I open at the top of the appliance and remove the stool before it has a chance to pile up and get under the flange. This works well as long as I have access to a bathroom, so if I’m at home, for example. If I need a long stretch without bathroom access, I need to do something else. So either I irrigate (it’s a form of enema for colostomy) or I use Imodium to prevent output for awhile. If you find something else that works well, please let us know. Welcome to the VO site.
Laurie
Thanks, I’m going to try this.
Yes, it will help! Let’s break it down:
The idea of covering the filter is to prevent the “vacuum" effect inside the bag, which causes the walls of the bag to essentially close up (like vacuum sealed products). Since you don’t have a filter, this would not be as big of a problem.
However, when you empty your bag, I would assume you push out the air, too. If so, then you are creating that same vacuum effect.
Stuffing toilet paper in the bag (not a lot, just enough to create a small ball) will help to keep the walls of the bag apart.
But… you can also achieve similar results by keeping some air in the bag after you’ve emptied it! This is what I do, especially when I’m on the bike and can’t micromanage my appliance the way I would in normal circumstances.
If you have gas, then this will happen automatically. For me, It’s extremely rare to have gas AND pancaking.
I hope that makes sense 😆
@chelly … pancaking after surgery is common. We are not drinking enough fluids after surgery, often due to fatigue and sleeping more. I.V. puts fluids into our veins, not on our food in our stomach. As you know, my guts are extremely runny & yet, I’ll still get pancaking on occasion. But I’m finding that has more to do with what I ate & how much I drank, to keep the fluidity of the output department. It is a pain , especially when you wake up because it feels like someone’s trying to stuff a square peg into a round hole, reversed!
There’s a few things I’ve learned to do. I leave more air in the pouch to have at least an inch above my stoma when the pouch is pressed on and closed. I up my fluids on meals that absorb fluids and drink plenty afterwards too. Like a noodle absorbs fluids to get soft enough to eat, foods that still absorb after eating, like fibrous foods, they need extra fluids too.
I love having an extra jug of V8 Juice in my cupboard for meals that may cause the issue, or for when I have trouble drinking enough fluids V8 original juice works great. Plus you can add more salt to it as well if need be. I have no issues with the small bits of softened veggie fibres in the juice causing any issues.
I’ve never found tissue in my pouch to be a helpful thing at all, but what works for one does not always work for another. My first plan of attack is to document on meals or snacks that caused the issue before, drink more fluids with that food & swish your abdomen & tummy around, wiggle, wiggle, wiggle until you hear the swish happening inside of you. I know it sounds silly, but give it a swirl, it works….lol.
I also elevate my sleeping position so I’m on more of a slant with my whole torso, not just my upper chest & head, and the output needs to slide down or it’s easier for you to slide it down half asleep. Keeping the output from getting beneath the wafer is huge for me. This is one topic I hate loising sleep over! Its a royal pain in the pouch!
My other go too when things slow down in the pouch is my stash of…
Adapt Lubricating Deoderant, on the box is … Lot 7E160 , then the expirey date & then its number.. #3862-02 . I move it around up to the top of my pouch and I can get away with using 1/2 a tube at a time. It comes in individual portions.
Good luck figuring out what works for you.