Managing thick output in a drainable ostomy bag can be a bit challenging, but there are several strategies that can help make the process easier and more comfortable. Here are some tips and insights shared by others who have faced similar challenges:

1. Mechanical emptying techniques:
- Open the tail of the bag and gently "milk" or coax the stool downward. A digging or undercutting motion from the outside is often more effective than straight pushing.

2. Lubrication inside the pouch:
- Add a small amount of baby oil to the pouch.
- Use a lubricating deodorant to reduce pancaking and help the stool slide to the bottom of the pouch.
- Leave a little air in the bag so the stool can drop rather than stick to the sides.

3. Thinning the output through diet and fluids:
- Increase your daily fluid intake, aiming for 80-100 ounces in total, with at least 60 ounces being water. Coffee and other drinks can also help.
- Identify foods that thicken output, such as starches and carbohydrates, and either limit them or pair them with extra liquids.
- Some people with an ileostomy use a routine dose of MiraLAX to maintain a looser consistency, but this should be done under surgical guidance.

4. Warm-water rinse method:
- Pour or squirt a small amount of warm water into the pouch with the tail open using a condiment bottle, large syringe, or water bottle.
- Close the pouch, swish to loosen the stool, reopen, and drain. Repeat 1-3 times if needed.
- Many users report cleaner pouches and reduced odor, though some professionals advise against this method as it might affect the wafer adhesive.

5. Closed-end pouch option:
- Switching to closed bags eliminates the need to empty thick output; simply remove and discard the pouch.
- U.S. Medicare allows up to 180 closed pouches per 3-month supply, which is about 2 per day.
- Some private insurers cover 60 closed pouches or 20 drainable pouches per month, along with barrier rings, remover wipes, barrier wipes, and lubricant/deodorant.

6. Helpful accessories and product notes:
- A two-piece drainable system with a convex flange, belt, and barrier ring can work well for uneven abdomens.
- Keep a condiment bottle at the toilet for warm-water flushing to speed up emptying and cleaning.

7. General reminders:
- Frequent hydration benefits both output consistency and overall health, especially for those with an ileostomy.
- Monitor for pancaking, which is when stool stays on the stoma face. Lubricants or a quick water rinse usually resolve this issue.
- Proper emptying and cleaning techniques can prolong pouch wear time and help prevent skin irritation and leaks.