Ileostomy Care - Managing Pancaking and Trusting in Heat

Hi. I'm still learning. What is pancaking?

What is trusting?

During humid weather with high temperatures or just high temperatures, wafers need to be changed 1-3 times a day, whereas normally the wafers were working for 2-4 days at a time. Does this always happen with heat?

Hello bethannnye

There are a few who have mentioned a loss of adhesion in the heat, but for me, it makes no difference.

Hi and welcome. Learning, you will be for sure. Pancaking is having a bulk amount of poop around your stoma that doesn't move. It just sits and grows... Usually, sitting a lot causes it, but also a lack of fluids. You were told to hydrate, correct?

Never heard the term "trusting" when speaking of stomas or appliances. Please explain.

If you think heat is causing the appliance to lose its adhesion, you might want to try a belt and extenders (referred to as C strips). Heat should not affect a quality appliance. Are you changing frequently due to leaks? Or dislodging the appliance?

What are you using to hold the appliance on?

If you scroll down, you will see a thread topic already in progress on pancaking issues. Check it out.

I had these same questions early on… Warrior is correct - pancaking is poop that fails to drop away from your stoma, causing discomfort (pressure and possible leakage around the edge of the stoma). This happens when there is no air in the bag and gravity cannot do its job, so poop continues to build up rather than falling toward the outspout. To help with this, I use a dab of baby oil at the spout of the bag - apply a small amount about 1 inch from the opening and squish around at the lower part of the bag (not on the stoma), sort of like applying oil to a pan to prevent sticking… then make sure you have a small amount of air trapped in your bag, which allows gravity to do its job.

I am guessing rather than trusting you are referring to crusting. This term (I believe) means that some folks apply stoma powder and barrier wipe solution around the stoma for protection against burning or raw skin - trying to build up a wall of crust, so to speak. The skin area around the stoma can be quite sensitive and becomes uncomfortable when poop gets into that area. Hope this helps… you will learn so much from this website… keep checking it for information and support… it's like a free doctor's office visit or call, and sometimes a darn good laugh is included! Best wishes on your journey. jb

Hi and welcome. I'm thinking you might mean 'crusting' too. Just to add to Justbreathe's good description of the technique, this is meant to allow your appliance to stick better to peristomal skin that has been irritated to the point of rawness. You are more likely to have skin irritation with an ileostomy because your output is more caustic. Crusting will not protect your skin from further irritation if the wafer is not cut just right. If the same area is exposed to output, even with the crusting, it will still get irritated. If you are able to cut to the exact size to prevent any output, then it's all good. I went for a couple of years dealing with irritated, raw skin, often enough that I finally tried a barrier ring and it was a game changer for me. No more skin irritation, no more worrying about cutting the wafer precisely (the barrier ring hugs your stoma and fills in the gaps, so you can be a little sloppy cutting your wafer with no problem) and the bonus is that it extends my wear time by at least a couple of days. There are lots of brands of barrier rings out there but my favorite is made by Salts and it's infused with aloe, so very kind to the skin. Good luck!

Terry

Words of Encouragement from Ostomy Advocates I Hollister

My advice would be to start with "crusting." If the heat is causing sweat, this may help. I almost always use at least a powder base as a start to a bag change; just make sure there is no loose powder residue before you place your wafer.