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
Watch this video on YouTube.
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).

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. One of my problems is an oily mucous that occasionally leaks from my stoma that causes the wafer to leak. I assume it’s from something I have eaten. But so far I can’t figure out what. Any suggestions?

    Also,after 9 months I am still trying to find an appliance that will stay on more than 1 or 2 days.

    Reply
    • Sandra, it is normal to have some mucous in your intestines. That’s what helps the stool to move along. If you think you have too much mucous or if there’s something unusual about the quality of the mucous, best to have that checked out with your doctor or ostomy nurse.
      Have you tried heating your flange slightly before you stick it to your skin? I have found that if I use a hair dryer (not on the hottest setting!) just to warm it up slightly, it will stick to my skin so much better. I probably get a couple of extra days wear from this. Just be careful that you don’t heat it so much that it causes a burn when you put it on your skin. 
      Laurie

      Reply
  2. Hi Nancy and welcome! You did indeed come to the right place. I don’t think there’s anything else like it for support, info, and shoulders to cry on when needed. BTW, what kind of ostomy do you have? No matter what you are facing, we are here for you. So many of us have been where you are now. Just knowing that, for me, is a comfort. 
    Stella

    Reply
  3. Hi Nancy and welcome, Ostomy after care can leave a lot to be desired! I would urge the use of this forum to learn and ask questions. A full and normal life can be achieved when a suitable appliance and routine are established. Best wishes going forward 👍

    Reply
  4. Glad some of you have Ostomy Nurses. My hospital didn’t have one. My husband went on YouTube to find out about diff brands and it was a try it and see what worked. I’ve had to learn on my own as I am stuck with a permanent Ostomy because my Dr did not leave enough to re connect. So it’s been a frustrating experience!

    Reply
    • Hi Nancy,

      Your experience is all too common for many people, unfortunately.

      I am glad that you have found information that can help you. It will get easier with experience, so don’t get too discouraged 👍

      Best to you!

      Reply
    • Welcome!
      I did the exact same thing! No real guidance from my surgeon or his nurse, so I got lots of samples to try and watched a bunch of videos and settled on  the 2 piece Hollister convex wafers with vented bags.
      Glad things are working out for you!

      Reply

Leave a Reply to GoatHerder Cancel reply