This topic is all about managing hydration and dealing with the issue of pancaking for those with an ostomy. Pancaking happens when the output becomes thick and sticks to the top of the pouch, which can be quite frustrating. The discussion revolves around how much water to drink, when to drink it, and whether it really helps with pancaking. Here are some insights and advice shared by others:

- Hydration habits:
- Many people drink constantly throughout the day, with 2 to 3 liters being common, especially for those without a colon who are more prone to dehydration.
- While extra fluids might not always change the thickness of the output, staying hydrated is crucial. Options like oral rehydration solutions, sports drinks, or adding salt can be helpful.

- Food vs. fluid:
- Thick and sticky output is often more about diet than how much you drink. Foods like pasta, potatoes, starchy carbs, and high-fiber foods can be culprits.
- To thin the output, consider coffee, soda, alcohol, or melons, though they might increase gas. Adjusting these foods and drinks can be more effective than just drinking more water.

- Medications & supplements:
- Miralax can be used occasionally to loosen thick stool.
- Imodium is used by some to firm up loose output, with the dose adjusted to find the right consistency.
- Chewable fiber tablets or natural fiber sources can help regulate thickness for some people.

- Lubricating the pouch:
- Rinsing the pouch after emptying or using lubricants like baby oil, M-9 ostomy lubricant/deodorant, PAM cooking spray, or even WD-40 can prevent stool from sticking.
- Regular lubrication helps keep the stool from building up around the stoma.

- Managing air and vacuum:
- Pancaking can occur when a filter removes too much air, causing the pouch to vacuum-seal.
- Consider using pouches without filters or leaving a small amount of air in the pouch when changing or emptying it.
- A small air pocket helps the stool drop, but too much air can cause ballooning, so aim for a small cushion.

- Emptying technique & equipment:
- A two-piece Coloplast SenSura Mio pouch can be opened from the top to empty early, preventing stool from reaching the bottom and sticking.
- Manipulating the output from outside the pouch can help move it downward if it starts to collect at the stoma.