Need advice on pancaking issue with Hollister 18194 Vented - Help!

Hi, and thanks for having me here. I am one month post-op and having issues with pancaking. This didn't happen in the hospital. The stool would run to the bottom of the bag and I would empty as needed.

Since I am home and getting some help from home health care, they supplied me with Hollister vented bags that drain from the bottom. I tried the Adapt lubricant with no help.

I was just able to loosen some stool and get it out, but the bag, just put on yesterday, has stool all around the top where the vents are and all over the stoma.

Can I get some water in the bag and clean it out or just change it? Don't think I like these vented bags.

Please help.

Joe Cal

Good morning, Joe.

Welcome to the site! We're happy to have you here and hope you find useful information and support. With time, perhaps you'll be able to help another new ostomate with an issue. :)

About the pancaking, I thought of two things:

Are you as hydrated at home as you were in the hospital post-procedure? I'm presuming you were on IV fluids, which provide consistent hydration. I know I don't drink as many fluids as I should - and I'm a 3-year plus ileostomate. Perhaps you need to increase your intake of non-caffeinated fluids to make your output looser, more free-flowing?

I experience pancaking fairly often, too, but use a Hollister one-piece that is not vented. (I also find vented appliances obnoxious due to the propensity for pancaking and vents blocked by the output - so what's the point in having them?? - so stopped using them.)

Yes, you can put some water into the bag from the bottom/draining opening and gently swish it around to loosen the output - several times, if needed. Or, work the front, back, and sides of the bag together with finger and thumb to help remove the stickier output off the appliance walls. Keep a good hold on the open end, paying attention that the opening doesn't dip down below "water level". (Messy to clean up.)

I hope this is helpful, Joe. Again - welcome! :)

Lily17

I like the idea of a vented bag, but pancaking always happened to me too, so I stopped using them. Coloplast has a new vented bag. I will give that a try and will request a sample. Most of the suppliers will send you free samples.

Hi Joe and welcome,

Go with what Lily said. At home, I use a 10 oz. soda bottle with water. It rinses and loosens it up, and into the toilet it goes. Be careful to hold the closed end tight, as Lily said! I get 3 rinses from that little bottle. If you need more, just refill the bottle again. One thing to remember is if you dump it often enough, otherwise it can push the bag off of your skin. And do it fairly gently; sometimes my stoma starts to bleed around the edge of the hole in the bag. Use Stoma powder around the edge if changing if there is any blood or rash. With clean-shaved skin wiped with water and dried, my bag changes can be up to 6-7 days before I start smelling something. Everyone's experiences are a little different. I'm sure some may touch on that. Any questions, holler; you will get support. Mtnman.

Hi Lily,

No, I don't drink enough fluids at home and yes while in the hospital I was on IV. I think while in the hospital they used the Hollister with no vent. I don't know why I ordered samples with the vent because that's when this all started. I never drank fluids, especially water because it makes me nauseous but I guess even ginger ale is better than nothing. Maybe I should use what I have and switch back to the non-vented. I think that is a big issue here. Thanks again. I am going to see what I can do about cleaning this one out just for the evening. It has just been put on yesterday.

Stay well

Joe Cal

I agree with Lily that hydration could be part of the issue. Try changing to the non-vented bags and see if that helps. I find that keeping a small air pocket in the bag helps some too. Rinsing isn't an issue, and if you're not comfortable drinking more fluids, then you can keep a small amount of liquid in the bag to help keep things fluid and moving. By small amount, I mean like a teaspoon so you don't add more problems. I find this helps particularly at night or when I've eaten something I know will thicken the output.

I have a problem drinking a lot of water, but I just forced myself to drink more than I used to. I do eat a lot of carbs, and that also causes pancaking. When I get ready to empty my bag, I add water to the end of it and roll the end up so the water can't slip out while I'm getting it to move to the end of the bag. I also use baby oil, and that helps it to slide down in the bag. Hope this helps. Best wishes and stay safe. Also, welcome aboard.

Hi, I too have pancaking problems. I have to use a vented bag for now, as I seem to be a gassy person. I tried the non-vented bag but would have to empty the bag 6-8 times a night, very little sleep. The vented bags only seem to work for 1 or 2 days before they no longer release the air, that gets more costly. I am working with a nutritional expert to try and control the gases filling my bag, and hopefully be able to get back to the non-filter, easier to use and clean bag. Right now, I have stopped drinking milk with my meals. It seems I may have become lactose intolerant after the surgery, which causes lots of gas in the bag. I stopped the milk 3 days ago and I do notice quite a difference. Food for thought... Thanks for being here for us.

Hopefully, my digestive system will straighten out after my chemotherapy treatments end in July. Stay safe... Fred.

Hi,

I do intend to go back to non-vented as they worked great in the hospital. The problem is right now we are getting about 1 foot of snow and samples won't get delivered for a while, and my nurse won't be able to get here for a while either. I'm down to only a few vented bags and starting to worry.

Thanks for everyone's input!

Joe Cal

Lily, just thought I would ask if there is any way to make a vented bag "unvented". I have a ton of samples coming tomorrow and they are all Hollister vented with the fold-out drain on the bottom. If I could "unvent" them, I can easily burp them when they inflate. If not, I am really stuck.

Thanks! Joe Cal

Good morning, Joe.

"Stuck" is the key word here, I think.

You want to manually plug up the vent on an ostomy appliance? When you get your samples in, and before you use them/place them on your body, rig up a way to keep the front & back walls of an appliance apart from each other. You can put a finger or two into the appliance either from the drainage opening, or pre-cut the appliance as you usually would for your stoma opening and access the interior from there. Then apply over the vent from the exterior side of the wall either:

- A Super Glue-type product. (Take my word for it: with Super Glue, the amount you will need to use in this process will increase the time it needs to completely dry, so be prepared for a wait.)

- Rubber cement. Let it dry, then cover the cement with a fairly large piece of strong tape so clothing doesn't wear off the cement.

- Stoma paste. Let it dry, then cover the paste with a fairly large piece of strong tape so clothing doesn't wear off the dried paste.

Give the chosen product time to dry completely. Maybe a third or fourth hand would be necessary if you add using a blow dryer on low or cool heat to speed up the drying time?

Whatever you do, ensure that when you finally allow the front/vented/glue-y wall of the appliance to touch the back wall, that there's no chance for them to adhere to each other. Obviously, you want the appliance to still be usable, or you might as well just throw it away, right? :)

As permanent as these options are, venting will have to be done manually once the vent is blocked.

Back to your thoughts on increasing plain water intake, and it making you nauseous, Joe. You mentioned drinking ginger ale instead, but what about drinking club soda? Still fizzy, but refreshing, no sugar, but could increase the amount of gas in your pouch. Note that depending on your health concerns and the type of club soda, you could be taking in quite a bit of potassium. It took me a long while to "enjoy" drinking plain water, but club soda (on ice?) could be something for you to consider. And it may be a "transitional beverage" to help you make the step to plain water?

Let us know how you end up resolving these concerns, Joe - and make it an amazing day! :)

Lily17

Hi Lily,

Thanks for the reply, but I wish there was a video on how to do what you said. I don't understand the process even though you explained it so well and may as well deal with the vented until I can get new samples.

As far as hydrating? I picked up a 12 pack of seltzer yesterday and have been drinking that. It's funny you brought that up. Still not drinking a lot, just sipping at it as the day goes by.

I'll keep you updated on the venting issue.

Joe Cal

If you want to try "closing" the vent, you could also try a small piece of duct tape over it.

Hi WIGirl. I tried tape on the outside of the vent but no help. I don't think tape on the inside would hold up. These bags are bad. I want the Hollister invented where you empty out the stool from the bottom. As gas builds up, it is way to just burp the bag. No more pancaking. Joe cal

Hi Joe and welcome to the site. Lily has some great points to follow. I use a vented pouch too but use a sticker to cover the vent and it eliminates most pancake issues. Try blowing a bit of air in the bag after you dump and wipe it clean as this will help eliminate the vacuum effect that causes the pancaking. I use baby oil in the pouch and have had good luck with how it lubricates. Good luck and stay well. Penguins7

I just am not sure what to block up. The white filter inside and out???

Hi Joe, the pouches with filters usually have the stickers in the box and you can adhere them to the outside of the filter. It was a big help for me to resolve the pancake issue. Penguins7

Hi Penguin.

I just got delivery of the vented bags. I will see if there are stickers inside and I guess they only go over the filter outside the bag. Thanks

Joe, 

Hi, you do get the little stickers to cover the vent in the box of pouches. They are not perfect but I use them when I shower, and if the vent stops working from being soiled, the output will ooze out of that filter. I will keep one on when that happens. You have gotten all the perfect advice for the pancaking! I pancake sometimes as well but have figured out how to move it down in the pouch just by pushing from both sides of the pouch downward. I do use a bottle of water to rinse just like Mountain Man does. Works perfectly, and you can actually clean around your stoma by swishing the water up there. Do NOT drop that pouch without it being sealed. That has been said several times, so you know we have made that mistake and it is not pretty! 
Puppy

Hi puppy

I didn't get any stickers in my sample pack. I will have to use what I have until the right order gets here.

Thanks

Joe Cal

Hi, Joe.

Allow me to simplify: You're going to use your fingers of one hand to separate - and keep separate - the front and back walls of the appliance. Then, coat the entire exterior side of the vent with the sealant of your choice, extending the sealant 1/8-1/4" or so past the outermost edge of the vent. Ensure the sealant is completely dry before allowing the front and back walls of the appliance to come into contact so they don't stick together. Then, place a piece of heavy-duty tape (duct, electrical, etc. or...a piece of Coloplast/Brava barrier strip or sheet!) over the entire area that you've sealed - large enough to extend over the edge of the sealant.

I'm glad you got the seltzer, Joe - another great option! Sipping beverages throughout the day is highly recommended for us ostomates by medical professionals. In fact, sipping is better than gulping as gulping doesn't allow the modified GI tract time to absorb the liquid and hydrate the body.

Let us know how you fare with this sealing process, Joe, if you decide to pursue it.

Lily17