Pancaking with colostomy

HI Danni 

Nice to hear from but not so good news about dads pancaking issues, the best way I can help you is to give you an insight into why it happens, what causes it and how do we cure it and yes it can be resolved

Sorry this is a bit long, but here goes if you're ready, deep breath and get ready to start reading -

Pancaking

Pancaking, not as tasty as it sounds, is a common issue for colostomates. The output of a colostomy tends to have a solid, formed consistency. This means it sometimes doesn’t drop into the pouch properly and instead becomes stuck to the stoma itself, creating a pancake. This can then cause the pouch to lift off the skin, which makes leaks more likely. Pancaking usually happens when the output has a particularly thick consistency. It can also occur when the pouch filter works too well at removing the air and inadvertently creates a vacuum.

Should you find pancaking on your stoma, the first thing to do is to thin the consistency of your output to help it drop into the pouch better. This can be done by drinking plenty of fluids and increasing the amount of fibre in your diet, perhaps by eating more wholegrains or certain fruits or vegetables.

To reduce the vacuum effect, you can cover the filter to keep the air in your pouch. A new box of pouches often comes with stickers for this purpose. However, a covered filter can keep too much air inside and cause ballooning, in which case the sticker will need removing as necessary.

If pancaking continues, there are some extra steps to take before you change your appliance. If you lubricate the inside of the pouch with baby oil or an equivalent, it can help the output drop into the pouch. Meanwhile, putting a piece of tissue inside can help reduce the vacuum effect. Trying a different type of pouch may help, and you can ask your nurse whether it might help to use a convex appliance.

Many ostomy suppliers have gels that can be inserted into the pouch to lubricate the insides.

One of the companies, Opus Healthcare have little foam pads in two sizes that can be inserted at the top of the pouch to keep the insides of the pouch apart and help the poo to fall the product is called "Stoma Bridge" please see

http://www.opus-healthcare.co.uk/clearway.htm

For more information

I hope this helps and your dad can be free of pancaking very soon if you need any more help please, as usual, give me a shout out I'm here to help at all times.

Regards to you and dad.

Ian

Hi Ian 

lovely to hear from you and thank you for that detailed advice I will pass this info on to my Dad and maybe he can try some of them things to. I’m always telling him to drink more but you know yourself it’s hard to drink all the time. That tissue one could help. My Dad gets his from coloplast I think it’s called or have I just named a product haha and I’m sure you can get a deodorant lubricant I think it’s called for it.

thank you so much for your quick reply as always. Hope your keeping well. Danni 

Hi Danni

No problem always pleased to help.

Don't worry about name dropping this is only group that we can share recommendations and manufacturers and supply companies.

As dad is using Coloplast, there you go I've name dropped, he can get a free body check from them where the product specialist will analyse all the information he gives them and come up with a range of products that could be suitable to him. I'll be honest it's a pain in the bum answering the questions but its worth it if it solves the problems and they will give  him endless samples until they find the right product.

He could call this number 01733368961 should get him through to Gabriella and she will do the body check for him. It may be that he just needs to change the style of pouch

See also

Sample
item

Brava® lubricating deodorant

The Brava Lubricating Deodorant neutralises odour and ensures content is always at the bottom of the bag and not around your stoma. It also makes the bag easier to empty.

Manufacturer

• Select your product
  Select one
• Quantity                                       ---                                  
• Units per pack: 
  Total no. of units: 
• Order sample   Add to basket

Hope this additional information helps, please let me know how he gets on

Ian 

Hi Ian 

yes that was the stuff I seen thanks Ian. Thanks might see if my Dad will do the body check maybe you can do it on line. Thanks for your help. Danni 

Hi Danni

It would better if you could get your dad to do it over the phone, probably take about 10 - 15 minutes to complete.  I don't think you can do it online as the product adviser builds up a picture as she is speaking to you, maybe you could do it for him if he was sitting beside you.

I honestly think it would be beneficial to him.

For thing I should have mentioned, get to dad to blow into his new pouch before he attaches it to his body with the throat at the foot sealed up, this will separate the sides and put some air into pouch

Ian

Hi Danni,

It used to be a problem for me, but it has largely gone away since I was switched to soft convex type drainable bags. Suggest he gives them a try to see if it helps. 

GM

HI Danni

Further to the reply, above, from  as mentioned in my original response Convex pouches are an option but if dad is not using a convex pouch just now he will need to discuss the change with his stoma care nurse to get approval for the change and she will probably have to see him to have a look at the stoma and examine the surrounding peristomal skin allowing her to suggest the best form of convexity for him together with suggesting which pouch would initially be best and a few different types of pouches may be introduced until the correct one is found.

All pouch manufacturers will gladly supply convex pouch samples but most dispensing appliance contractors will not change orders from flat pouches to convex pouches without a stoma nurse authorising the change. I know of one DAC who will not supply a change of pouch from flat to convex even if a GP sends a prescription until the SCN has confirmed that it is okay for the prescription to be fulfilled

As your dad, I think, has a Colostomy which normally has a closed pouch his stoma care nurse would want to discuss with him the difference between closed and drainable pouches

Whilst I'm here I gave you a link to opus healthcare, I was speaking to them this morning and they told me because they were doing essential maintenance of their web site patients could not order sample products direct from them at present and patients are advised to ask their SCN to obtain necessary samples, my view over the years they have been more than generous with their samples and they are tightening their belts

Hope you have a good weekend.

Ian

Hi Ian,

Yes agreed. I assumed that the discussion to change would have to be via the Stoma nurse. It was they that recommended mine. 

GM

Hi Ian 

thats great thank you for your advice I told my Dad yesterday  about all these tips so thank you it’s much appreciated. 

Danni 

Hi Guitarman

Nice to heat from you, hope your doing well. Thank you for for your advice so you think the drainable bags help with the pancaking - I will pass this info on. I’m sure my Dad said he has the convex bags but I know they aren’t the drainable ones but then obviously some days he can change them a few times. Can I ask do you shower with yours on or off as my Dad usually leaves them on but today he left them off but struggled to get them to get them to stick to skin after? Thanks Danni