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

Ostomy Pancaking

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

Ostomy Care Tips: Dealing with Pancaking
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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).

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.

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?

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

  1. So much to learn. I am so 😕 and sad.maybe I am not capable or strong enough. Glad to have found you a cry for help from me

    Reply
  2. I feel like the coloplast sensura mio bags especially have the problem with pancaking. The “check valve” system they have in the pouch caused stool to build up when my stoma was very active. I tried the lubricating deodorants and even baby oil. The baby oil would work for bit, but then it would start to leak out from the filter. the hollister bag which I now use do have pancaking, but not as bad as the coloplast pouches.

    Reply
    • Yes, I agree with you about pancaking/leaking with the SensuraMio bags, which is why I decided to try the Hollister with the convex faceplate. I have since discovered that Coloplast also makes bags with convex faceplates. Am considering trying one of those. Will post findings if/when I do.

      Reply
  3. Hi there. Have been trying light convex Hollister bags, which really help ease the pancaking – at least it’s easy to swish out the stuff from around the stoma.
    The problem I have with this mfgr’s bags is the smell! Even a small amount of stool in the bag is obvious. Their supplied deodorant doesn’t do a thing to help.
    Has anyone else experienced this odor situation? THNX!

    Reply
    • @Lucy

      Hi Lucy, do you notice odors when the bag is closed or only when you open it? There should be no odor from the outside of the bag. I use Hollister M9 deodorant drops and it’s very effective at removing odors, even when the bag is open. 

       

      Reply
      • The odor is there whenever there is any amount of stool in the Hollister bag. Yes, even when closed. This particular model has no filter so it does require “burping” but of course one would expect a smell then, but just “hanging there”, with even a small amount of stool, it smells. Their deodorant did nothing.

        I had been using Coloplast SensuraMio #10481 but had problems with pancaking and leaking. (But had no issues with odor.)

        So decided to try the Hollister #89811 with which I am pleased because pancaking/leaking seems to no longer be an issue. The adhesive seems to better agree with my skin as well. It’s just the odor…

        Am less than 6 months with my colostomy, and I’m getting the impression that I’ll just have to keep experimenting to find the “right” product for me.

        I’ve been reading the discussion on odor and may try some of the suggestions.

        Thank you for your reply, as well as for providing this valuable forum!

        Reply
        • Update: am trying a different Hollister bag (#8578) and so far, no odor! Perhaps the batch of #89811’s was defective? Live n’ learn, eh?

  4. Hi

    Putting water while emptying pouch can help to make stick stool becomes more fluid. From where is it safer to put the water, from the bottom or the top?

    Awaiting for your advice.

    Thank you

    HM

    Reply
    • Hi Hassen, when I empty my pouch and use water, I always put it in from the bottom while holding the open outlet upwards (so no water spills out). What I do is once I put some water in the bag, I close the outlet and swish it around a little to loosen the stools.

      Reply
  5. I am a new ostomate and I am having a really hard time finding a bag/system that doesn’t leak. My stoma seems to be recessed in my belly…so I think I’m not getting a good seal…I have had days that I have to change my entire bag/wafer 4 times a day, due to leaking. .that is reaking havoc on my skin, as you can image. I’m glad I found your videos…I’m learning a lot …I’m still looking forward to getting my life back again. I had one week since I got out of the hospital that a bag stayed on for six days with no leaking!!! That was the best!!! Can’t wait to master this thing so I can get back to my life!!

    Reply
    • Posted by: Lori Wooten

      I am a new ostomate and I am having a really hard time finding a bag/system that doesn’t leak. My stoma seems to be recessed in my belly…so I think I’m not getting a good seal…

      Hi Lori, 

      You may have answered your own question :) Generally speaking, for flat or recessed stomas, the usual appliance you’ll want to use is a convex one. If you are using a flat wafer, then you will likely have leaks in this situation. 

      Are you able to speak with a nurse to talk about the option of trying a convex wafer? Every brand has them, but they often differ in the amount of convex they have and how firm the convexity is. You don’t want something that’s putting too much pressure on your skin as you may develop pressure sores, so it’s important to try and speak with a stoma nurse before making any changes to convexity. 

      Good luck!

       

      Reply
    • Lori, I had a horrible time with this at first too. Here are a few things that made a world of difference. I now use a convex wafer- like Eric mentioned. Your bosomy nurse can usually provide you with a few different types/ brands to try. Also, before applying a new wafer, I dry my peristomal skin with a hair dryer on low heat. I also warm the wafer using the hair dryer. I now have to change my appliance every 3 days (max) because of ongoing skin issues, but the above steps made leaking almost non-existent for me. I hope this helps!Marci

      Reply
    • I had problems with this as well. My stoma nurse switch me to a Coloplast convex wafer and voila! all problems disappeared. I change the wafer about every 3 to 5 days and haven’t leaked since.

      Reply
    • Hi
      I’m also relatively new ostomate and noticed that my stoma became more recessed as it settled (3 months) after surgery. I changed to a Convex base plate which has extended the wear time.
      I kept using the Coloplast Sensura mio bags despite the pancaking issues as other bags I tried came unglued, ballooned and made rustling noises when I moved

      Reply

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