Tips for Pancaking and Pasty Output with Colostomy?

Aug 28, 2017 2:33 pm

Hi everyone. This is about my husband. He has a colostomy. It's permanent and it's new. Just about a month now. It's not flush with the skin so we use convexity appliances, but we are out right now and only have the flat ones. Any tips on how to help? I read something about blowing in the bag before you put it on? Any advice would be appreciated. Also, his output is really pasty which isn't helping. Anything work to harden it up? Thanks.

Aug 28, 2017 3:31 pm

I have an ileostomy, so the output consistency is quite different, as is the management.

Many people choose to irrigate, with a colostomy, in order to regulate the time of output. It's usually done once a day.....and the bowels empty within the 1/2 hour. Takes about an hour, start to finish. After that, your husband would just need a small stoma cap, or a small pouch, in case of any leaks. But remember, "gas" can always blow off the pouch, so carry extras.

Output from a colostomy varies in consistency. The more colon you have the more fluid is absorbed. If it's mushy, he might want to eat more fiber, but that could cause backup. Mushy is preferable.....Some people put oil (veg/or baby) in their pouch, so feces can flow down. If he's using a pouch with a spout, he can empty it, otherwise he would need to change it. In that case, a two-piece would be better than a one-piece, so you don't have to change the wafer every day....just empty or change the pouch. I hope this helps. Ask for more advice from people with colostomies. Don't be afraid to be specific. Best of luck to you and your husband.

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Aug 28, 2017 4:23 pm

His ostomy nurse mentioned it is irritating. We will talk to her about that again for sure. He has a pouch, so he empties it. It's just that since his stoma is indented, it's hard to get the poo to go in the bag. He does oil the bag up though. Thanks for responding :)

Aug 28, 2017 9:41 pm


Your keyword is that it's new. It does take time for his digestive tract to adapt. Over time, the output should thicken. I have an ileostomy and yes, I have found it very beneficial to blow into the bag a little before attaching it to the wafer.


Aug 28, 2017 11:36 pm

Hi. I have a colostomy and I do use convex pouches. They definitely help as they push the stoma into the pouch.

But if you can't get them, roll up a piece of toilet paper and put that inside the pouch. This keeps the pouch separated. And yes, oiling does help. A seal around the pouch does help also.

There is a very good product we can get here in New Zealand called Loperamide. They are capsules and I swallow 1 a day which helps with the pancaking. Recommended by my Stoma Nurse. No more though or you could get constipated. I believe you can get them in other countries. I can get them through the Doctor which makes them a lot cheaper here.

Best wishes from New Zealand. Ngaire.

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Aug 31, 2017 6:50 pm

I have developed a hernia and pancaking can be expected from the colostomy. That said, my stoma site bulges outward and I use a flat one-piece bag. I started irrigating several months ago and now have little issue with pancaking. Not that stool doesn't pancake, but the irrigating process minimizes output. I average 1-3 days for irrigating. Sometimes I still have a small amount of output, so that depends on how often I irrigate.

Lots of talk not to irrigate with a hernia, but I manage pretty good. Sometimes the stoma wants to stay closed, so I switch between 2-piece and one-piece if things don't go exactly as planned.

My ET nurse introduced me to irrigating and this site has lots of practical advice if you search the forums.

Good luck


Sep 01, 2017 7:12 pm

I've had my share of issues with pancaking, and what works for me is the little white circle of tape that comes with my pouches. If I don't put one over the "air vent" on the filter, I will get a vacuum effect that keeps everything from falling downward.

Hope it helps your hubby.