Advice Needed: Preventing Pancaking and Output Issues with Ileostomy Bag

Hi,  I had my ileostomy Nov 2010 and wondered if anyone had any tips to prevent pancaking and output collecting in the top of the bag when I lie down.  It's really hindering my ability to sleep, although my stoma does seem to go into warp drive at night and I have to get up to empty it every 1-2 hrs anyway.  I'm hoping that will settle down with time.

Are you cutting to fit the stoma? I was cutting smaller than I should have, strangling it! The ET nurse showed how I should cut... and better, and drink lots of fluids... I could go through 2 jugs! I still wake up at night 3x, 2x/depends on what you eat as well.

Hi all, just an opinion here as I've been there. First, if you have a size of your stoma, they have cards with sizes already measured and if you get precut flanges, any spaces can be taken care of (if necessary) with adapt rings which will help push waste away and help with pancaking and increase the life of the wafer. You may already know all this, just trying to be helpful. Just remember to get the precut as close as possible over the size of the stoma. Ed

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If you can help it, don't eat right before you go to sleep. This may prevent your bag from filling up in the middle of the night. I find that on the nights I don't eat anything after dinner, I can make it through the night without having to empty it. Another trick I learned is if in the middle of the night you think you need to empty your bag, just get up and do it. If I dwell on it too much (should I or shouldn't I get up), I can't get back to sleep. If I just get up and empty it, I'm usually back in bed snoozing in a few minutes (unless my wife wakes up and wants some action!) (LOL).

Hi Thing. I am a newbie too, October Ile. I was getting leakage, pancaking, and just about anything else that can go wrong... until I discovered by trial and error and talking to my ostomy nurse and this forum that to really get a good seal, do this (just a suggestion)... I use a one-piece Coloplast. When I put the seal on (I use Eakin), make sure that you mold the seal a little bit inside the hole for the stoma. Then I put my hand over the flange and seal for 10 minutes so the seal gets warm. Some people use a blow dryer on low for a minute or so to get the seal to set... I don't know if I am explaining this right. The old-timers are probably rolling their eyes. All I can say is it works for me and I don't have many problems. Only eat lightly at night, make sure to empty before you go to bed... I don't know what else to say to help, but it works for me. You will find something that works for you. I know it is all strange, scary, new, and weird... you'll get through it, I promise. yaya
p.s. Let me know how you are doing. I'll be thinking of you and wishing you well.

Getting Support in the Ostomy Community with LeeAnne Hayden | Hollister

Welcome to the forum! Your ilio will adjust in time. I have found what works best for me is not eating anything past 6 PM. Also, foods like bananas, rice, applesauce, toast, breads, pastas—all cause a slower output and will cause pancaking. I've heard where some people add some cooking oil or cooking spray to the inside of their bag and they say that helps the contents slide down easier, but I have not tried that myself.
I use the Coloplast 2-piece convexity system. Have been using it for 7 months now and have had only two leaks and change the system every 5th day.

Thanks everyone.  Lost so much weight from the Crohns/UC (still in debate which it is and got to go back for more tests!) before the surgery that I'm on a weight gain diet so that's probably not helping but the sooner I regain a couple of stones the sooner I can have a reversal (fingers xd).  I tried the cohesive slims but couldn't get on with them.  I use cohesive paste to fill in gaps between the stoma and bag but it doesn't last all day because my stoma changes size so much I guess.  Anyway I've ordered some 2 piece bags to try, these might make it easier

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Do you use Immodium? This really helps.

All such great responses as I also found it took a few different products until I found the right fit. My stoma is flush to my abdomen so I also use the Eakin small seals which work much, much better than paste, for me.



Mostly, however, I would advise that if you have access to an ET nurse I recommend you make an appointment. I was hesitant at first as well, but was so happy afterward because she was able to find the right "fit" for my stoma and stomach. It will also save you the trouble and expense of trial and error.



Be well.

I have had a colostomy for 6.5 years and they have been the best years ever! I have this blessing permanently and it is a blessing. Without it, I would be so miserable. Just a thought:
Do what you need to do, see a WOCNurse, and figure it out together. I also have Crohn's and UC, and so what? One day at a time and keep searching for your answer; my skin changes all the time and I now have a raging rash, but will figure it out with my "people", so do the same!

I don't eat after 4 PM, or I'm up too much during the night emptying the bag, or with a blockage. I have lots of scar tissue and am prone to blockages, so I must be very careful about what things I eat to begin with. Good luck. Some foods take so much longer to go through the system, such as beef, apples, and hard fruits or vegetables.
Go to the ET nurse, or get referrals. Hang in there—it will get better. I had my ileostomy back in 1990, and have no regrets—so glad to get past ulcerative colitis.

Similar advice to what has been said before, really: don't eat too late, try to eat stuff that will thicken the output (greenish bananas...), and don't drink water (it goes straight through; try flavored squash instead).
To help with the sealing, have you tried the LBF wipes? They help me a treat.

Hi there "Newbie" and welcome to the world of Ostomies!

All the responses are great tips -- My doctor suggested I eat 5 - 6 small meals each day rather than the usual 3. Watch what you eat. Drink plenty of water, especially because you have an ileostomy.

I conduct a small support group and have published a booklet of "Tips." You can find it here:

                http://www.premiersystems.net/ostomy-alliance/ostomates.pdf

Bayonne Ostomy Alliance
"Lighting a Candle Amidst the Darkness"
Meeting 2nd Wed. Every Month
2 PM @ Bayonne Medical Cntr.
Cardiology Conference Room

Welcome, Thing 1. I feel like Thing 2 a lot of the time. I've had my temporary ileo for 4 years now and have gone through lots of trials and tribulations. My ileo is very fluid, and seldom do I run into pancaking; however, I do use an Adapt oil that I squirt into the bag just before applying the bag. This seems to help because everything just slides down. I've heard from some people on this site that use good old baby oil, and that supposedly works just the same and smells nicer!! Hey, we need all the help we can get.
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Does your bag actually fill so much so that you need to change every 1-2 hours, or are you being precautious? If so, with time you will start to relax and get a bit more sleep between changes, and don't drink a lot of fluid before bed. Good luck with all of the advice you are getting from everyone here. I find I get some of the best answers from this site. So welcome aboard!... Cathy

I had my ileo a year ago. Ileos generally put out liquid waste because the colon is not in use. If you're pancaking, I think you are not drinking enough fluid. I like G2 by Gatorade and Light CranRaspberry by Ocean Spray. I have a high volume bag which drains easily when I pull the plug. After a while, you will find that your body has certain times of the day when you discharge a lot and other times when you don't. Fortunately, my midnight to 5 am is very quiet. Anyway, as the song from The Student Prince goes, "Drink, drink, drink".

Hi, I usually place lubricant in a bag, then a small piece of paper. It helps let the fecal matter go well into the bag.    Also, watch your diet.  I use a large bag now. It saves on mess. I have had a stoma for about 5 years and had a couple of mishaps.
Unfortunately, no reversal until I get lower than 5 mg prednisolone.!!!!! The first time I went into the hospital with septicaemia,  Dr said, "THE BAG OR THE BOX!!!!"  Urgent Op.


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