Pancaking Issues with Ileostomy Bag at Night

So I had my ileostomy created only 3 weeks ago, so it's very new. I use convex bags because it's quite small and in a dip, and stoma nurses have just given me new seals to use as well due to the separation. I was given advice to use the stickers in the box to cover the filter to keep air in the bag, and I don't have a problem when moving or lounging during the day, but when I lay down at night to sleep and then wake to empty my bag, there's always some sitting around the top, like up where the filter is and around my stoma. I don't really know what else to try because it's only really an issue at night; it doesn't leak or seem to seep under the wafer, just the top of the bag gathers a collection, and I then can't clean the top of the bag to get it all out. I push as much as possible down when I empty. Any advice?

Hi. Welcome. First bit of advice is don't listen to your nurse about those stickers. They are there to prevent contamination of water while showering. A sticker covers it. Never use it to trap air. That's ridiculous advice.

Members agree filters, when wet, are useless. In general, they don't work. The jury is out on long-term use... Do you have a one-piece system? I'm guessing you do. To cleanse it, there's a bottle available to squirt up inside the bag to loosen the poop. Might be a bit messy.

A two-piece appliance allows you to turn the bag to fill and rinse. Much easier as far as cleaning.

Pancaking while you sleep only??.. ..how do you sleep? On your back? Sideways? Are you using a wrap when sleeping or keeping it hanging freely? How often at night do you empty?

Ileostomy here…I use a one-piece system that has no filter. I have tried several systems with filters, but I do not like a filter for a few reasons.

1. They seem to get clogged, especially at night.

2. I haven't much confidence that they will completely eliminate fumes from escaping.

3. I need a certain amount of air trapped in the bag, allowing output to help gravity direct everything downward.

With a bit of air and a couple of drops of baby oil, the pouch becomes like Teflon.

I am a side sleeper and a belly sleeper, and I find a bit of trapped air provides a buffer between the stoma and pouch, resulting in no pancaking.

You are new, so there are many answers, and not all will fit your requirements. Stay in touch with this site, and in time you will find what works best for you. Good luck and onward and upward…jb

This bottle we found on Amazon, but we stopped using it when water was getting in behind the wafer. We could have been using a little too much pressure as Hubz has a colostomy with thicker output, but with less pressure, it might work for what you're trying to do. I also watched a woman on YouTube put water in her bag after emptying and splash the water up into the top of the bag to clean the area above the stoma. Hubz now pours water in the bag before emptying to get more out sooner. 

As for filters, Hubz keeps a layer of air in the bag to prevent pancaking (output getting stuck at the stoma, not moving into the bag, being pushed out sideways under the wafer forming a big pancake), due to the release of air creating a vacuum inside the bag, keeping the bag closed tightly around the stoma, preventing output from moving away even as more output arrives. The vacuum is as extreme as those storage bags used to store bulky sweaters in the off season!

A piece of waterproof tape goes over every filter before applying the bag. Air goes into the bag with a blow dryer or just hold the outside of the bag away as you close up. It doesn't take much to create that layer of precious air.

All these suggestions came from others, mostly on this site but YouTube as well. Just try different things to see what works for you!🙂

Hubz just found this great summary about pancaking!

🔒 Login to see image

No. 78501 is a lube for your issue by Hollister. Give them a shout-out for some samples. It might do the trick. Good luck and welcome. We're here for you.🌈

How to Manage Emotions with LeeAnne Hayden | Hollister

The nurse is right; a sticker can be used to stop air from coming out of the bag, but what works for one person doesn't work for another. Try it without a sticker for a week or two and see what happens. It sounds like you have quite solid output, which is a good sign. At three weeks, it's usually more watery that early on; it could be just diet-related or just normal for you. If it's bothering you that much, just flush the bag out with water or ask your stoma nurse if they can add lubricant to your prescription. And just a word of advice: if you don't already know, you are exempt from having to pay for prescriptions in the UK if you have a permanent ostomy. You just have to pick a form up from your GP surgery, fill it in, and take it back for the GP to sign. In a few weeks, you will receive a credit card-sized medical exemption certificate.

Hello New To This Life, welcome!

I can only confirm the tips described. Do stick the sticker on so that some air remains in the bag. This prevents pancaking caused by vacuuming. I also use the bottle shown.

You can rinse the bag before bedtime, and afterward, I use Brava lubricating gel in the bag.

Air pressure? Vacuum? Hmm🤔 I must be doing something wrong.🤦

An ileostomy now 9 yrs. No issues with pancaking. Unless I sit. When I sit, it just gathers on top. Standing, it does fall south. I wear the bag vertically sometimes but mostly horizontally all day. Nighttime, vertical. Free. No wrap. Just the belt (flange).

Diet plays a big role in getting your shitz liquid enough to move. How you sleep matters too. I don't put air into the bag. After emptying, I knead the bag to get the poop out, turn it up, add M9. Close it.

The air inside the bag is from gas. The filter is supposed to eliminate that gas from causing a balloon effect.

Every bag with a filter I use is useless in trying to do that. So for me, filters don't work. Especially when wet. The stickers I have been told are used specifically for showering, to prevent water contamination of the charcoal filter.

It's not a one-way check valve device. It works both ways, I understand that. But I can't imagine it sucking in air with gas present from shitz in the bag. The way I see it, it pushes air out. Or tries to. When clogged, it can't. Thus ballooning happens. Just my experience for whatever it's worth. 🤷‍♂️

I might be one of the few people with an ileostomy who experiences this. But especially in the morning, the pouch creates a vacuum.

Then the output has nowhere to go, is going for a pancake, and then leakage quickly occurs. This has to do with the filter and the pouch's construction. And of course, also with the way my stoma functions.

Many filters are designed for people with a colostomy, I think. Air is transported directly out through the filter. For a while, I used material that immediately destroyed the filter by wetting it. Then I also put the sticker on it, and sometimes the air could still escape.

Currently, there are two types of pouches where this doesn't happen: Salts Confidence (which I used with the sticker) and the new gray Convatec pouch. I don't need a sticker on this pouch. And the pouch always stays flat with a little air. So, my compliments on this design!

Both of these pouches have a double layer of plastic on the front. And small S-shaped openings have been cut into that extra layer of plastic.

I have been looking for material without a filter, but I have always been told that it is not available in the Netherlands.

Thanks for sharing👍.. We all have different views on this topic and experiences. You have 15 years as an ileo, and Ben I think has 40.

You might be some of the few, but proud, stomarines. 😊

So there is that.

My stoma must be the best well-behaved stoma on the planet. So I'm not complaining or trying to cause issues with pancaking. Just voicing my own experience. I don't see vacuum affecting my pouch. Gas and balloon—sometimes—is related to diet.

If one plugs that filter daily with a sticker, nothing good will come from it. Air in the bag and sleeping on it? I just see "boom-splat." 🧨 Roll over, play wet.

Just my opinion. I know filters.

You say you are using a convex wafer. Does your stoma stick up far enough to escape the bowl of the wafer?

I use convex wafers on both my ostomies, and neither of them sticks up sufficiently. I find that during the day, I am moving around enough that waste finds its way into the bag. But at night, when lying down, the waste tends to accumulate in the bowl, basically due to gravity.

It isn't exactly pancaking, but I don't have another word for it. It seems to be a unique phenomenon related to small stomas and convex wafers. If this is what's happening, it isn't your fault. I don't think there's a cure short of switching to a flat wafer, but that's likely to cause other problems.

I wear 2-piece appliances, so I remove the bag and clean the area. I think you can devise a water cleaning routine that will work for you.

Thank you, I just followed advice; it's so new to me.

I do have a one-piece system; I'll look at the bottles. It's always worth a try.

I tend to sleep mostly on my side, but sometimes I end up on my back. I don't have a wrap; I have the belt thing that I wear all the time, as it was just given to me, and no one said I need to take it off, although I do for showers. Most of the time, I empty before I sleep and then maybe once at like 6 a.m. when I wake up, so not often. I don't know if it's just thick and sticky, so it doesn't slide down.

Thank you, that's very helpful! I'll ask my doctors about it.

Yeah, I saw the stoma nurse the other day, and my stoma is small and still healing, so it may possibly get smaller. I have a seal to put around the stoma, but I have to cut my bags bigger due to granulomas on the skin around it. My body didn't like the stitches, but I have Ehlers-Danlos syndrome as well, so I think that's probably what's happening—gathering in that bowl area at night. We tried flat wafers in the hospital, but because it's in a dip, it leaked continuously, especially at night, so I have to use convex. I'll try some water to clean it, but it's not going onto my skin because of the seal, so it may just be something to accept, really. At least no one else can see it, and I can push the majority of waste out; it's just very thick, especially in the morning.

Susan,

Thanks for sharing… seems as though you may have identified a need for a new ostomy word/term …

How about “Puddling”…. I take this to mean the indentations immediately under a stoma or dips, or as you say, a bowl around a stoma where waste tends to puddle…. What say you? Possibly two words describing this particular problem. Mayhaps there is already a special ostomy directory on this site…. If so, I have not stumbled on it, which is not surprising as stumbling seems to be my only way around MAO in general 😂

jb

Puddling sounds wet.

Crater? Pothole? Could work.

I'd hope when we develop certain lingo or terms, we stay away from food...please.

Pancaking? Wafer? What's next?

And remember, A.I. has no humor or common sense.

Spell check will have a field day, 😆 too.

Ha ha examples from spell check - bowel? (delete)

below? (delete)

vowel? (delete)

be well? (delete)

blow? (delete)

towel? (delete)

Bowl is quite accurate, though. 🤔..good one👍

Hello, I was just looking online for an irrigation bottle for cleansing around the stoma. This is AU dollars; Amazon is about $28, and on AliExpress, they are about $5. They sell it for nasal irrigation. You have to spend $15 to get free postage, but I was looking at the shower cover, and they were about $12. Just always remember to double-check for postage before hitting PAY.

The more water you drink, the less output will gather around the flange. Also, some high fiber foods—baked beans and homemade vegetable soup—will loosen the output and create air in the bag. It can be quite noisy, so maybe try it at home first.

Hugs, Jennifer

Warrior…lol

Cow pie?

Oops, you might misconstrue it as a food item 😂 jb

I think the cow would be more offended than I, dear.

🤣

jb

Maybe you should get up to empty sooner? Are you drinking plenty of fluids? Also, you can tilt your bag to the side if you sleep on your back. Just move your bag so that the end of it is pointing to your side. That is what I do, and it usually works. Sometimes there is buildup; usually, that's when I have a leak. But that is once in a blue moon for me. Watch what you eat before bed; don't eat foods that thicken output, like pumpkin, squash, etc. Sometimes bread will do it for me too. I set an alarm to wake me up at midnight to empty my bag, then go back to sleep until morning.