Tips and Tricks to Avoid Ostomy Pancaking

A common issue ostomates face is pancaking. It can sometimes feel like you have tried everything with no luck. But don’t give up! I have compiled this troubleshooting guide based on my experience as an ostomate and dealing with my fair share of pancaking. Give these tips a try to limit pancaking in your pouch.

What is pancaking?

Pancaking is a term often used when describing ostomy output sticking to the bag at the stoma site and not falling down as it should. This causes the stool to form around the wafer and “smoosh” itself into the shape of a pancake.

Pancaking can be a hassle! I get it often because I have a colostomy which is more likely then an ileostomy to pancake because the stool is thicker. I also tend to wear tight pants with my pouch tucked into them – preventing stool from sliding down to the bottom of my bag. I’m going to be honest with you, my stool almost never falls into my bag on its own, I have to guide it with one method of another. So how do I manage?

Dress for Success

• Loose fitting pants with a tight waistband. I find that dressing for my ostomy is helpful for many situations including the prevention of pancaking. Loose fitting pants with a tight waistband can be beneficial. Make sure to have the waistband sit just above the stoma, applying pressure to the top of the bag. This and more leg room will encourage the stool to fall properly. Scrub pants work well for me at work because the waistband applies pressure and the pants are loose, allowing the stool to fall down.
• Tuck in your bag. Also, folding the top part of your bag down and tucking it into the waistband can limit the space available for pancaking. This also helps keep the stool from accumulating around the filter – preventing a clog.

When all of this fails, and sometimes it does fail, the crease is my bag has usually done its job of protecting my filter and top of my bag. Then I can just go into the restroom, squeeze the sides of my bag, and run my fingers along the pouch to squeeze the stool down. I also sometimes use a flat “karate-chop hand” and slide it down the front of the bag gently. But when doing this, I am careful not to put a large amount of force on the bag because this could compromise the seal by squeezing stool under the wafer. I slowly and carefully push the stool down a little at a time. It is important to just try and push whats on the outside of the wafer, not the stool that’s inside the flange circle. To deal with the stool inside the flange circle, I gently us my finger to guide it down into the bag, then squeeze it down as before.

Convex Wafers

When it comes to pancaking, some ostomates say that convex wafers cause more pancaking. Because convex wafers are curved to place pressure around the stoma, the thought it that stool can pool in the “cup” created by this shape. I find though, that pancaking is more of an issue of the stool spreading to the bag surrounding and sticking to the flange circle, creating a short stack you didn’t order.

When I first got my ostomy, pancaking was a problem and caused frequent leaks. This occurred until I began using convex wafers. I find that my convex barrier prevents leaks when pancaking occurs and creates a good enough seal to allow me to gently squeeze the stool down.

Other Tips and Tricks

When I was having major pancaking and leaking issues, nurses were still coming to my home regularly. While helping me adjust after surgery my nurses taught me some tricks:

• Inflate the pouch. If your pouch does not have a filter, blow air into the bag and pull the walls apart from eachother before putting it on. This puffs the bag out so that the stool can fall to the bottom. If the bag is collapsed, it prevents stool from falling down.
• Add toilet paper. If your pouch has a filter, inflating the pouch won’t work because air will leak from the filter causing it to collapse. Roll up a small piece of toilet paper and insert it into the bag. Roll into a little tube like a pie crust comes rolled up in a box – this keeps the bag open, allowing stool to fall properly.
• Lubricate. Laura recommends lubricating your pouch. You can use things like baby oil or olive oil as long as these don’t compromise you seal or decrease your wear time. To prevent this from occurring when lubricating your pouch, try using a commercial lubricating deodorant made specifically for ostomies: Adapt, Adapt purse size, Brava, and Lubricating gel deodorant. When lubricating your pouch make sure that you are evenly distributing the lubricating drops around the pouch to ensure it is slippery. Try to get the gel around the wafer site as well as down into the pouch. You can do this by smooshing the pouch up in you hands with the drops inside and manipulating it around. Laura also recommends increasing your fluid and fiber intake to help make your output less sticky and prevent the stool from being able to stick to the bag.
• Cover your filter. Eric from Vegan Ostomy says that sometimes a filter can work so well that it “pulls at” the bag trying to rid it of any gas, creating a vacuum within the bag. If this is occurring, it will certainly cause pancaking by almost vacuum-packing the stool around the stoma site as it comes out. If you think this could be the case with your filter, Eric suggests covering the filter on the outside of the bag with a sticker or a piece of tape to prevent the vacuuming situation. Then, if gas accumulates in your bag, you can simply remove the tape for it to be filtered out and recover it after.
• Try a different pouch. If you have tried everything and still can’t avoid pancaking, you may want to look into changing the type of bag you use. A different appliance may have a less active filter, a more slippery inside, or different material that prevents pancaking of your stool.
• Ostomy Liners. Colo-Majic is a plastic bag that goes inside your ostomy and fans out around the flange. You then clip your bag to the flange over the bag rim and the bag sits inside your pouch to collect the stool, leaving the pouch clean. Although I have not personally used this product, I think it might be worth a try. It seems like this would work because of the product’s hourglass shape. The top part of the liner bottlenecks, and the liner slides down into your pouch, with no room for it to slide up. If you are feeling adventurous, give it a shot. This product is also flushable!!! So you can flush your poo, not throw it in the trash at a friends house where their dog can pull in out and chew it open right in the living room… ahem.

I hope this long list of ideas contains something that can help you out!

Happy Ostomy-ing,

Kelsey

You can find more articles and videos about living with an ostomy below:

• Ostomy Hacks: Dressing with an Ostomy
• Ostomy Buzz – The Latest in Ostomy Management Recorded Webinar
• Ostomy Skin Issues: Your Solutions
• Wild and Free with an Ostomy: Music Festivals / Camping / Concert – Tips and Tricks
• Tips for Swimming with an Ostomy – More Security | Ask Laura