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?
Welcome Onalee,Happy you found this place. Be sure to watch Eric’s video ‘untimely Leaks’ under ‘tips’ in the video section.Very reassuring .. not a total blow out but in a car park: https://www.veganostomy.ca/videos/One of my favs!
Hi Eric,I just found your website and I am in tears to FINALLY found the answers to my problems. Two years ago,I was diagnosed with Rectal Cancer. I had the whole nine yards,Radiation,Chemotherapy,Surgery then more Chemotherapy. I ended up with a permanent Colostomy Bag. For two years I have been dealing with the same as others I have seen on here. I finally have a name for the stool not coming down in my bag,collecting around my stoma causing the wafer to come loose and leak. I have tried explaining it to the Doctor and he did say eat more fiber and drink more fluids. Trust me I drink enough fluid,I have a 100 oz mug I use.I think my problem is I am flattening my bag to my body therefore causing a vacuum. I am SO self conscious of my bag. I pull my underwear over my bag just so it doesn’t show over the top of my pants. The thing that is hard to deal with is being in public and having it leak MAJORLY. Nothing like being in a stall of a restroom trying to change not only your bag but yourself.Hoping that stool won’t land on the floor. You lose your dignity . I carry a backpack with me everywhere I go,with my supplies and change of clothes.I am so glad that I found your website to answer my problems that I might come across. By the way don’t you wish it was easier to change yourself in public? Rest Rooms just are not equipped for people in our boat.I try to go to places that has the diaper changing table in their stalls. Or a lone bathroom. Not that putting my supplies on the sink is any easier.I just take one day at a time,and hope that this day will be a good day.
Glad you found me, Onalee!
If you can find a “family bathroom" they tend to be better suited for an appliance change. However, I would recommend either carrying a change it that can hang in a bathroom stall or get a small hook to hang whatever purse or bag you normally keep your supplies in.
I try not to assume that I’ll have access to a sink, counter, garbage bin, etc. Always be prepared.
Take care!
Great idea about the hook – I’m gna include a suction hook in my bag of tricks now! I have an illeostomy and always have a plastic grocery bag in all of my vehicles with a cleanup kit – ie: a couple of spare appliances, a small pack of baby wipes, a couple of sheets of paper towels, clean pair of knickers and a singlet, ANOTHER grocery bag to wrap the final wee pile of rubbish up in (so it can be neatly disposed of in the sanitary napkin disposal bin – usually found in the ladies restroom). I put the 2nd grocery bag on top of the closed toilet lid (or handbasin if there’s one in the cubicle, the baby wipes pack and strips of ripped paper towel on the cistern, then work from there. You don’t need water if you have baby wipes with you, they’re excellent for cleaning up baggy blowouts. I find that sections of paper towels torn into long strips are awesome for the final mop up of any moisture around the stoma just prior to slapping on that new bag – helps with the stickability.
The size of this spill kit is minimal, it will fit in a handbag, deep coat pocket or backpack etc.
To be honest, once you’ve had a stoma for a lot of years you stop being so upset when accidents occur. I’ve been caught short at times without my spill kit, have found a loo and just used loo paper to jam up around where the leak is until I can get home. Usually when out riding my Harley! 😅 Cripes, I even cart around little dog pooh pick up bags for emptying my appliance contents into if I’m in desperate need of getting rid of my bag contents while out in the wopwops somewhere – baby wipes are great for this too, just empty your bag into the doggy doo bag, do a quick wipe off of the bag closure with the baby wipes and you’re good to go. You can pop the doggy doo bag in the boot of your car or into another plastic bag in your backpack etc. until you can dispose of it properly.
As for pancaking – I’m always dealing with that due to a thicker stool output…have discovered that wearing larger capacity bags has helped manage it way better. I eat a whole food plant based diet, so tons of fibre, my smaller capacity bags just weren’t coping. Also, using the Salts Mouldable Seals in conjunction with my illeostomy bags has stopped alot of leakage problems.
Onalee
I had problems with pancaking initially 10 years ago and found a Cymed product that I could wear consistently for 3 days. Every other manufacture’s product would pancake in less than 24 hours….some in less than 8 hours. Cymed changed their wafer and adhesive in July of 2016 and the new one would not last more than 10-12 hours(pancaking). I started my search for a replacement and tried all the major manufactures again. I found success with Salts out of the UK. They are super helpful and nice. Get a sample of their convex CDSS1325. It works for me…I can wear it 3 to 4 days.
I’m fairly new (9 mo) but I have found Gatorade and Powerade hep to loosen my stool. If that’s any help
I have the same problem as you and am at my wits end, I just don’t know what to do. Have tried different pouches but still get the pancaking. Have tried the pushing it down to the bottom of the pouch but usually I end up with a leak. Have had since Sept 2015 and still frustrated
I have had my colostomy for 2 1/2 yrs and just lately I am having difficulty with the pancaking and it leaks out. It is very embarrassing and I am paranoid. I have had to change the pouch three times in the last three days and my skin is getting very raw and sore. I also have a permanent colostomy cant be reversed so I need to figure out how to solve this problem. It is getting quite expensive besides being painful. Any suggestions
Hi Esther. Have any of the suggestions in this article helped?
It sounds like you may have multiple issues going on – the raw skin won’t help, so that should be addressed.
Have you been able to speak with a nurse about these leaks? If it’s not related to the pancaking, they should be able to offer a few suggestions on what to try next.
Best of luck to you!
Thank you, I have read the articles here but none have worked in the past. One nurse told me to pour water in the pouch to clean but think maybe that’s why the pouch leaked the water broke the seal. I dunno just grasping now
Ester –
Everyone is different so not sure if this will help. I have had the bag for 10 years. It took me a couple years to find the right appliance. I used Cymed and it worked great for 7 years. Had to change it every 3 days and rarely had any issues, and had no worries. They changed their wafer and adhesive and they would pancake frequently..I sometimes had to change them 3 times per day. Cymed no longer makes an appliance that works for me.
I tried samples from all major manufacturerers. They only one that works for me is from Salts out of the UK. Come to find out they manufactured the wafer/adhesive for Cymed until they changed their supplier. Not sure if it will work for you but contact Salts (they are great to work with) and try a sample of their convex CDSS1325. I do not like the convexity and I sometimes have an issue with the edges curling, but they last 3 days and my skin is healthy.
Good luck,
Tom
Hi Esther,
Rinsing your pouch with water probably isn’t helping the situation, so I would stop doing that for now and resume once things are back to normal.
It sounds like the primary issue is the leaking and the pancaking may be a secondary problem that’s compounding the issue. I would still recommend speaking with a nurse to address the leaks/skin issues first, and while you’re doing that, see what you can do to reduce the pancaking.
Since you’re also a colostomate, have you discussed the possibility of irrigating your stoma? This would basically flush out any stool in your bowels at a scheduled time and would reduce the likelihood of pancaking.
How would I go about flushing my stoma or does it have to be done by a medical person, nurse or Dr
Hi Esther,
If you’re talking about colonic irrigation, then you’d be able to do it yourself once you’ve been shown how :) If you have a colostomy, it’s worth looking into (ask your stoma nurse for guidance).
Pancaking is quite frustrating, and if dietary changes don’t help and other techniques aren’t working, you won’t be left with many other options.
Best of luck!
Hi 😊 Have you tried the Salts Mouldable Seals? They’re VERY sticky and nice on the skin. I really rate them. I fit them to my bags as opposed to applying to the skin around my stoma. Has worked well for leakage issues 😊
Hello friend,
No matter how new or how old the videos are..or better yet, “the message’s" I find the help I need with what you have to teach us. I myself am dealing with very watery or very thick stool’s. For my more thick stool’s, drinking a coffee cup full of very warm water solves the problem almost right away. (I found the answer in your vlog) I’m sure the reason my stool’s are thick is due to my diet..also, I take a narcotic type medication, and depending on how often I take it, it I think will thicken it more so then if I’m not taking much. Also, I know I need to drink more healthy fluid’s, such as water, healthy juice’s from time to time would be beneficial. My bad..I need to drink more period! It’s I’m sure a good way to keep your insides healthier too.
Eric, you told me once to try and eat smaller meals through out the day because I was having trouble being up all night dumping my bag, and same during the day. I have found that by sticking to a more regulated diet, a structured diet has made my life alot less stressful. I’m not perfect, I do mess up from time to time and have struggles, but usually find the answers right here on your channel. You have been a blessing for sure!
Ok, the other reason I wanted to leave a comment was I was reading where a lady had trouble, small blockages, and not much output during the day but at night. She also said the opening to her stoma due to a surgical error was partially under her skin as well a bit above. I have this issue as well.. I had my second stoma revision a few weeks ago, still just a bit below but oh how it has made a huge difference. Now the trouble I still deal with is leaking on the skin just under my stoma. I love how the cohesive rings help, though I think my next bag change I’m going to give the past a try. My only concern had been, will it come off my skin like the ring?? We will see! Anyway, just to let the lady with that concern, yes…a revised stoma helps. Also, its Important that the Dr make sure no kinks. From her troubles, sounded like a possibility. I think Eric, you were concerned about that too.
Anyway, l feel like such a comment hog when it comes to your posts, and vids’..but I can’t help it, you have totally changed my day to day life! I truly owe it all to you Eric! I could not have gotten through these past several months without your help! I still struggle with issues not related to my stoma and diet per-say, more wound issues. I’ve had 5 surgeries since this past Oct..don’t want anymore! I have to say though.. because I’ve been trying to eat healthier, get more rest and drink plenty of water, my wounds are healing better. So again, thank you! Still, when it comes to concern’s I have about my iliostomy, I know where to go to see if the answer is in something you have written or talked about. For example, I’ve been having alot of belly sounds, gergling, air sounds etc. I was wondering if I could still have a partial blockage maybe without knowing. I don’t have pain, but at times pressure below stoma area. Or in my case..I have a huge hurnia that after I’m all healed, I WILL deal with! Curious though..is this common in Ostomy paitents?
Ok, so…
I still am coming to terms with the fact I have an iliostomy, not happy about it, and hope to one day except it. Having you on my side does help 100%. I have a hill to climb here, alot to take in even still. I’m sure many of you out there in my same shoe’s. One of my biggest concerns is..will I be able to care for this when I’m older??! Or, if I have it reversed, will I have bowel obstructions after. Insurance issues etc. I need though to focus on my day to day, not worry about tomorrow. I know this, yes. Just hard sometimes. Eric, time to get your therapist license..lol You could be an all in one for us Ostimates! Lol
Thanks again, and have a wonderful week ahead!
Mary
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 😀