Ileostomy Pancaking: Tips for Prevention and Management

When you have a bubble, you're going to have trouble.

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This is the start of what's called "pancaking," where output just collects around the stoma area and doesn't drain to the bottom of the bag, especially after standing.

The next stage is a bubble that will form, growing increasingly larger and putting sideways pressure on one's ring or paste adhesive, and forcing output under it, causing a leak.

Once the output, which contains active bacterial digestive enzymes, hits your skin, it begins eating it, causing skin burn wounds to occur along with some pain.

So although diet and portion control can assist with eliminating pancaking, it still sometimes catches one by surprise, so they need to watch for it before it causes far worse damage.

The remedy is simple: do a dump and pour some water into the bottom of the bag to flush, do it again, and seal up. Go lay on your back and get the water up around the stoma area and gently massage through the bag to loosen the output and clear the stoma. Don't squeeze the bag or try to push the output; that places pressure on the paste or ring just like the pancaking would. Flush and rinse the bag well.

An extra trick is to use just a few drops of antibacterial dish soap to kill the digestive enzymes in there and wash out the bag. The residue soap left over does a good job of eliminating the next future dump odor and cleans the bag as well or else leave a little water and soap in there to mix with the next output.

Now add a little air to the bag by leaving the end open and pulling the two sides of the bag apart to eliminate the vacuum effect. An effective method is to have a flat coffee stir stick or tongue depressor and insert it into the bag which then you can separate the two stuck together pieces of plastic. Once wide enough, close the end to trap the air and gently roll the bag up, thus forcing the air to the top of the bag and around the stoma. The bottom will cling together some to keep the bubble of air near the top.

Check your diet that you're not eating too many liquid-absorbing type foods like crackers, dry bread, and cookies without sufficiently mixing enough water with it in each mouthful.

Good information. Thanks 

I get pancaking with a moist sticky output. Moistening doesn't help. I have a colostomy and use a 2-piece system. For a while I thought I could control it thru diet but results were inconsistent.  

What seems to be working for me is removing the bag at the first sign of trouble, cleaning the stoma with the aid of a wash bottle, then replacing the bag. Rinse and repeat as often as necessary. 

I used closed end bags so I use a new one when replacing (thoroughly sprayed with cooking oil and a commercial lubricant/deodorant). For those needing to reuse bags, I'd consider cleaning and adding whatever lubricant ritual you use for a new bag. 

Tbh, I am not convinced the lubricant is helping at all but I am not ready to experiment with leaving it out. I think it does help some people but possibly not me. Everyone is different and all that... 

Why do we need a picture of that? 🤮 You do things the hard way. Simply fill your bag with warm water as full as you can and still be able to close it. Slosh it around for a few seconds and empty like normal, literally takes 10 seconds. I do it almost every time I empty. Add in whatever type of lube a person finds that works for them and work it around in your bag once you’re done emptying. 

Personally, I think the lube helps with the bag not sticking to itself more than helping the output fall. I will say if you can get the Revel It’s In the Bag lube to work for you, it is by far the most lubricating stuff I’ve tried. 

Staying Hydrated with an Ostomy with LeeAnne Hayden | Hollister

I corrected the headline to reflect this is for those with an ileostomy.

Different situation for those with a colonoscopy obviously; their colon is extracting water to thicken up stool.

A simpler solution is to put some air in your bag and push the air to the top where your stoma sits, so when you're thick, this won't happen.

And I agree with Alex; this picture was unnecessary. We all have an ostomy and are aware of what pancaking looks like.

G-Day All, Totally agree with Alex. Whenever I do a dump, I also wash it out with water. Showing photos of this is just a drama queen in action. Like Alex said, fill it with water, close the bag, give it a good agitation, and then let it go. Regards, IGGIE

People posting pictures of their stomas is just as gross in my opinion.

But you know what?

I realize this is an otosmy site for us ostomates and if we can't post our pictures here to show others our problems and issues then where can we go?

If the mods have a problem with it then they can delete it and send me a notice. 

Trolling from behind a keyboard is for cowards.

The issue is you’re posting pictures just for conversation and to post. Others post to show their personal problem and ask for help. 

Funny, the sign on the door says "Otosmy Tips"

Don't worry I won't make it a habit as long as IZZY can behave himself. 😆 

When I first started I didn't know what pancaking was or anything really.

I posted this for newbies to see what happens so they can catch it themselves.

Sorry if it grosses some out I won't make a habit of it.

As long as my demands are met. 😆 

I didn't know what pancaking was when I first started either. After it ripped off a couple of appliances, I figured it out. 🤣

I don't think it matters much whether the pancaking occurs in a colostomy or an ileostomy. I think eating changes are more likely to have an impact on ileostomy output and colonostomies are more likely to be dry because we do still have a colon to absorb water. However everyone is different.  

In my case, I would truly love a dry output. It wouldn't stick so badly to the stoma and would fall down into my bag. I use closed end bags so no emptying worries. I had this in the hospital when I was on pain meds but since then, I get my output is mostly the consistency of water alternating with thicker, very sticky output that always pancakes. 

My biggest messes have been when I get a the sticky output followed by liquid coming at force. Enough said about that! I imagine that this might as easily occur with ileostomates as well as colostomates. 

My solutions to the problem may work for others. That's why I shared. Though the swishing with water described after my post sounds more practical for those using open ended bags. It's basically the same idea. 

I appreciate the diversity of ideas because what works for one may not work for all. I try everything to see what works for me. 

Aside to Beth22: I am also putting a small peice of tissue near the top of my bag to ensure I keep air in it when I attach. I have no idea how you keep the air at the top since it tends to move around... 

Either did I when I first got an ostomy, and when it happened, I researched it. It was nice that you wanted to explain, but the picture wasn't necessary.

Hi Susan,

The tissue trick never worked for me. I had even tried double-sided butting a makeup sponge at the top when I first started, which only fell right back to the bottom of the bag. And you don't put a lot of air in the bag. You put some and you gently push the air to the top of the bag. And just make sure there is only air around the stoma, not the whole bag.

I'm posting the picture to show newbies the first warning sign of pancaking, which doing something at this point is important to avoid further complications.

Once the pancaking bubble starts forming, it's already too late for most.

Now you and others may hide their problems behind opaque bags and stealth belts, but newbies need to watch for the warning signs.

So in this case, I think the image is warranted and necessary.

Shows how much you know about what I wear. And me. I wear a clear bag. And I am actually the last one to hide my problems, which is why I think the statement above is hilarious. I am very proud of my ostomy and having one, and don't have a problem showing it off, but when my bag is shown off, I do give others the curiosity so they don't see the contents in my bag. I don't have an issue with my output. What I am saying is no one wants to see your output and what you ate for lunch or dinner. And as newbies, they will learn the way all of us have, and I didn't say anything about you explaining it. I said the picture was unnecessary. And FYI, I don't wear a stealth belt, lol. Nice try.

😆 

I like when mine "pancakes"! I wear a two-piece Holister, and when that occurs, I unsnap the top and take a Q-tip and flip it in the toilet, much easier than having loose stool, then clean with a wet wipe, so much easier than going through all that!

Problem with a two piece Hollister "click" appliance I was using was it would separate so I wound up super glueing the bag to the wafer.

So I'm not fond of two piece systems unless it has a clamp of some sort to prevent unwanted separation.