Most ostomates probably didn’t expect they’d ever come to dread the word ‘pancake’! Having a stoma comes with a unique set of challenges, most of which we have covered in our Stoma Problems blog. In this guide, we wanted to dig deeper into stoma pancaking which can be difficult to overcome for ostomates. Continue reading for our top tips to prevent pancaking in a stoma bag from the former stoma nurses on our team and conversations with patients. You will find out why your stoma bag is pancaking and how you can stop stoma pancaking.
What is pancaking with a stoma?
A pancaking stoma is caused by firm stools sticking to the top of the stoma bag. Usually, stool should fall to the bottom of the bag but if it is particularly thick or sticky, or the bag has vacuumed, it can get trapped at the top around the stoma. This can make emptying or changing your stoma bag particularly challenging.
This can happen to people with a colostomy or ileostomy, although it is more common in those who have a colostomy. This is because, with a colostomy, the stool travels through more of the colon and so becomes thicker and more formed. Looser stools, more typical of those with an ileostomy, tend to slide down the bag much more easily.
Stoma pancaking can cause leakage because the stool builds up around the stoma and has nowhere else to go other than underneath the baseplate. This, in turn, can lead to skin problems and can even cause your stoma bag to come off. The filter may also get blocked which causes ballooning issues.
Why is my stoma bag pancaking?
Clearly, a pancaking stoma bag can cause a lot of further issues, so it’s important to prevent it wherever possible. But before you can do that, you need to understand why your stoma bag keeps pancaking.
Stoma pancaking is usually caused by a lack of airflow into the pouch which causes a vacuum so the inner layers stick together and go flat (like a pancake – hence the name). This could be because your stoma bag filter is working too well and causing all of the air to leave the bag.
It is influenced by the consistency of your stoma output. Thick or sticky stools are more likely to get stuck at the top than loose ones. This is affected by which part of your bowel is redirected, as well as your diet. Learn more: Foods to eat with a stoma bag
How to stop stoma pancaking
So how do you stop pancaking in your stoma bag? Here are our top tips:
- Rub a small amount of baby oil or liquid soap to the top of the inside of the bag. This can help the stools slide into the bag by lubricating them. Avoid this touching the filter because it may stop working.
- Put a small piece of cotton wool or rolled-up tissue inside the stoma pouch when changing it. This allows airflow and can prevent the sides of the bag from sticking together.
- Blow some air into the new bag before applying it. Apply the filter cover to your filter to stop this air from escaping. You can then remove the cover when your bag fills with gas which you want to allow to escape.
- Try the Ostoform FLOWASSIST seal which has solved pancaking issues for some patients because its unique chute directs stool into the bag (see photo below).
- Increased fluid intake – especially fruit juices – can soften the stool and make it less likely to get stuck.
- Increasing insoluble fibre intake could also help to loosen your stool, such as eating wholegrains, bran, brown rice/pasta, berries and green veggies. Find out more here. However, always speak to your stoma nurse or doctor before making significant changes to your diet.
- Try moving the stool down to the bottom of the pouch using your hands if you notice it is stuck.
- Check that your clothing isn’t restricting the bag.
Contact your stoma care nurse if you are experiencing problems with a pancaking stoma. They can help you find the right combination of stoma products for you to mitigate the problem. They may also recommend medication such as stool softeners or laxatives (don’t take these without consulting a medical professional first).
Helpful links
Pancaking stoma advice from ostomates
Although all our articles are written alongside qualified medical professionals, this information is for guidance and does not replace advice given by your healthcare team.
