Strategies to Manage Pancaking After Ostomy Surgery

After my surgery and once I was home, it took a while for my appetite and taste to come back. My food intake still isn't where it needs to be currently, but it is getting better progressively.

With me eating more, I've got a problem where my waste is pancaking around the stoma. I learned the term 'pancaking' from a stoma website. The waste is pasty and adheres to the stoma and doesn't want to descend into the bottom of the bag, thus they call it pancaking.

I've alleviated this issue somewhat by flushing my bag with tap water to help loosen stool, drinking more water, and trying to eat a more healthy diet to facilitate the waste being easier to pass down, but this doesn't work most of the time.

There are products on the market for ostomy patients to spray in the bag to help waste fall to the opening (like an oily film), but these are pricey given my limited income. I've read that even using olive oil will help, but with inflation prices, even that is high now.

Has anyone on here experienced 'pancaking' and if so, what was your solution?

Thanks

You can use baby oil to lubricate the bag, just a small amount. If you have insurance, they should provide ostomy lubricant in your prescription. Otherwise, what you're doing is about all you can do. Leaving a little air in the bag helps too. I seem to deal with pancaking more with a new/fresh bag than I do once a bag is a couple of days old. 🤷‍♂️

I had the same problem after the surgery. Taking a stool softener 1-2 times per day and also increasing my fluid intake did help me.

Hello eab3691.

Thanks for your question, which does come up on here from time to time.
There are several useful ways to try to avoid pancaking but my approach was to think about ways that could hold the stoma snuggly enough for the output not to remain stuck to it.
The technique is described in the rhyme 'DIY stoma guards' and there are pictures of the devices on my profile.
I did think that the Salts Dermacol stoma collar was a great idea and it can work quite well in guiding the output to where it should go. However, it wasn't quite what I needed for 'other' reasons apart from pancaking, and my DIY device works on several different dimensions.
Best wishes

Bill

 

DIY STOMA GUARDS.

I did not think it would be hard
for me to make a stoma guard
that could be a perfect fit
and would let shit flow out of it.

The stoma guards I fabricate
would have to fit on my baseplates
and also they’d accommodate
attachments that would act as mates.

Attachments that I had in mind
were bags and sleeves of different kinds,
for routines that are set for me
to help manage my ostomy.

Some other useful things I use
are guidance systems that I choose
to fit upon the baseplates so
it helps the output freely flow.

So, these are things to think about
before I made a stoma spout
to fit upon my baseplates to
contain the stoma, not the pooh.

Looking back, it made me smile,
searching shops for quite a while
unscrewing lids to containers 
while seeking stoma constrainers.

And all the time that I did roam
the answer was right there, at home,
for ‘bathsoak’, which my wife had bought
was just the thing that I had sought.

The top of the container had
a shape that didn’t seem too bad
and what was more, its base was flat,
but I had not considered that

                                                            (continued->)

DIY STOMA GUARDS. (continued->)

The base acts as a wafer, and
for those who may not understand,
a wafer is the thing that sticks
to the skin for a firm fix.

So I cut off the bottle’s head 
but left the wafer on instead, 
then, the next thing that I do
is to remove the bottle’s screw.

There is a lip around the top,
which does seem handy as a stop
for the O-ring that can be
an add-on, for security.

This o-ring’s there to hold in place
a plastic sleeve, which helps displace
the output from the stoma to
the sleeve, then into the loo.

I thought that I should have regard 
for the gap between the guard
and the baseplate so, no spill
would lodge in there, there’s an infill.

The shape of this is smooth and nice
perfect for a guard device
that holds the stoma firm right to
the narrow end that is in view.

Of course, it might be better if
such a device was not so stiff
but, as it cost me nothing, I
will just be glad it gets me by.

I hope the pictures and the rhyme 
helps to show in space and time
precisely what this guard’s about
and how to make a stoma spout.

                                                B. Withers 2024

 

Make sure there is a little air in your bag so it balloons out just a little to allow most of the stool to drop to the bottom.

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Agree on all counts with comments from Alex above.

IMH experience - [not au fait with US insurance limitations] - ... I guess plain vegetable oil [less pricey than olive oil] may be helpful ...

 

Like Alex says, regular 'new bags' as a clean bag works best ... But after applying the bag [assuming you are using a drainable pouch] then just blow some air into it before rolling up to seal - This input of air, IMHE, is key when output is 'sticky'.

 

Best wishes from across the pond.

 

Jayne

Several responses have hit on my controls, but I'll chime in on my personal experience.

First, formed to semi-formed stools never pancake for me - only my soft stools pancake, so fiber is key (qualifier: "for me" - everyone is unique, your experience may be different). I ensure that I include something that is fiber-rich with every meal. I eat oatmeal each morning, fibrous veggies with each meal, and I supplement with a bite or three of those carb balance wraps (18g of fiber!) throughout the day.

Secondly is air. Without air, the bag will press up against your stoma, and any soft stool will immediately stick to it. I always ensure I have some air in the bag before closing it up.

Next is lubricant. I use olive oil, but as others have suggested, any vegetable oil should suffice. It's much less expensive than the actual stoma lube products. But once I put in the oil (and air) and seal the bag, I tip the drain end up to get the oil near the stoma and rub the stoma-facing part of the bag in the oil so that it's well lubricated.

Finally, bag washing works. If pancaking does start, it won't stop until you either wash or change the bag. Washing is a lot less expensive... 😉. I use a bit of hot water and swish it all around in the bag a few times to wash out the sticky stuff (then rinse and repeat as needed), then add fresh lubricant. Do be careful with this though, you don't want to get the vent filters wet or you'll be plagued by stoma aroma.

And if all else fails, of course, bag changes can get expensive. I really hate the one-day bags, but those are rare these days. I most always get two, and often three days lately, by doing what I've described above.

Find what works for you, and I wish you the best of success in this part of your adventure.

My wife picked up some baby oil (it's cheap) and I use a bit of that and it has worked well lately. I also wash my bag out multiple times a day to help with stains, stool adherence. It's a learning process. Love the advice I got on here from you guys. Y'all are the best!

I can't seem to live without taking a capful of MIRALAX every single day. When I don't take it, my stools pancake, every time. And, drink water, water, water… especially in this summer heat!