January, 2019

Question:

I have had surgery on November 20, 2018, to remove rectal cancer. I am now dealing with a colostomy, the removal of my rectum, the reconstruction of my vagina and skin grafts. The recovery is slow. I am having issues because my stools are very dense and heavy which leads to pancaking and leaking. I have tried lubricants and baby oil to no avail. I am having a very hard time emptying the bag as well because it is so very compact. I am not sure what to do to deal with this. Any advice would be appreciated. Thank you.

Response:

I often have to deal with the issue of pancaking, and it is frustrating.  Pancaking is a situation when the output collects around the stoma and can squeeze between the flange and the skin instead of going into your bag. One of the reasons this happens is because there isn’t enough air in the bag and so the output doesn’t take a downwards turn.

It is often recommended and as you have indicated, for some people the lubrication of baby oil or one of the many products available from the various supply companies can help. Some ostomates squirt a little oil or gel in their bag and give it a good rub around before they stick it on.

Another possible approach is to check to see if you’re wearing cloths that are tight fitting in the stoma area as this can also cause pancaking. You may want to try to wear looser fitting clothing in order to prevent a vacuum forming inside the bag. Also, in terms of clothing, make note of where your waistband or belt sits. Does it allow the stool to drop into the pouch or does it restrict the stool so the stool gathers only at the top. Monitor your body positions. If you are sitting for long periods for example driving or at the computer, does the pouch fold onto itself not allowing the stool to drop but remain in the top part of the pouch?

If the pouch has a filter in it, block the filter by either using waterproof tape or the ” tabs” that come in the box of pouches. This will leave air in the pouch, preventing the vacuum effect and allow to stool to drop into the pouch.

Another reason for pancaking is that your output is thick. Each person is an individual and so, each of us has trigger foods that can cause digestion processing issues, and stool issues. It would be helpful to consult your physician for a referral to a nutritionist or dietician to assist you in identifying foods that will work best for you.