Pancaking occurs mostly with a colostomy, when output is thick and tacky making it stay at the top of the pouch and preventing it from dropping down to the bottom of the pouch.

To manage pancaking:

• Make sure that you drink enough clear fluids during the day, this will help soften the motion. The recommendation is for 2 litres or 6-8 glasses per day, unless your doctor has instructed you otherwise. Clear fluids are water, herbal teas, apple juice, etc..
• A bulking agent like Metamucil (available from your pharmacy) will help with the consistency of the stool, adding bulk and weight to encourage stool to drop to the bottom of the pouch. Bulky agents are only helpful though if you are drinking the necessary fluid intake.
• If stool consistency is too thick despite attention to diet and fluid then a stool softener or laxative may be useful. Discuss with your Stomal Therapy Nurse or doctor what might be useful.
• Put a small amount of lubricant (hair conditioner or oil will also work) into the pouch before putting the pouch on. This helps the stool slide to the bottom of the pouch and prevents the pouch plastic from sticking together or forming a vacuum.
• A small piece of tissue or toilet paper in the pouch will also prevent the inside pouch plastic from sticking together and prevent a vacuum forming.