This topic is about dealing with "pancaking" issues when using Hollister 18194 vented drainable pouches after surgery. Pancaking occurs when the output sticks to the top of the pouch instead of flowing to the bottom, which can be quite frustrating. Here are some helpful tips and insights to manage or resolve this issue:

1. Increase fluid intake:
- Dehydration can thicken the output, leading to pancaking. Try to sip non-caffeinated drinks regularly.
- Fizzy drinks like club soda, seltzer, or ginger ale are okay but might increase gas.

2. Switch or modify the pouch:
- Some users have switched from Hollister vented pouches to non-vented ones or tried the new vented Coloplast pouch, which offers free samples.
- If you have to use vented pouches, you can block the filter using filter stickers, duct tape, electrical tape, or Coloplast/Brava barrier strips. For a more permanent solution, use Super Glue, rubber cement, or stoma paste covered with strong tape. Ensure the pouch walls are separated while the sealant dries.

3. Keep a small air pocket inside:
- After emptying the pouch, blow a little air into it or leave a teaspoon of water to prevent the sides from sticking together.

4. Rinse and loosen output:
- Use 4–10 oz of water from the bottom drain to rinse the pouch. Hold the tail closed, swish, and then empty.
- Gently "milk" the pouch with your fingers to help move the stool downward.

5. Lubricate the pouch:
- Use Adapt Lubricating Deodorant, baby oil, or a few drops of oil to help the stool slide to the bottom.

6. Empty frequently and gently:
- Avoid overfilling the pouch, as thick output can lift the seal. Frequent emptying reduces pressure.
- If the stoma edge bleeds, apply stoma powder during changes.

7. Manage diet and gas:
- High-carb foods and lactose intolerance can increase gas and pancaking. Consider reducing milk intake or consulting a nutritionist.
- Vented pouch users noted that filters can clog within 1–2 days. Blocking them can save pouches but requires manual "burping."

8. Skin care and wear time:
- Shave and clean the skin, let it dry, and a pouch can last 6–7 days. Change it sooner if you notice leakage or odor.