Living with an ileostomy for 17 years, the poster has recently been facing a challenge known as "pancaking." This happens when the stoma, which usually protrudes, sometimes retracts or "hides," causing the stool to travel behind the baseplate. This can lift the adhesive, irritate the skin around the stoma, and lead to leaks. One particularly tough night required four complete changes of the appliance, which has understandably affected morale. The poster is seeking practical advice to manage this situation.

Here are some helpful tips and insights:

1. Keep air in the pouch to prevent negative pressure:
- Blow into the bag before applying it or after each emptying.
- Leave a small air pocket and cover the vent/filter, or use non-filtered pouches if needed.
- Some people find it helpful to fold a piece of 3-ply toilet paper or carry a straw to introduce air.

2. Lubricate the inside of the pouch to help the output slide down:
- Swish a few drops of baby oil inside the pouch.
- Add Na’scent deodorizing liquid or another odor remover along with the oil.

3. Use barrier rings, washers, or protective sheets to protect the skin and fill gaps:
- Flat rings, Dermacollar, Brava Protective Sheet, or other barrier rings can help reduce seepage.
- If the stoma occasionally retracts, try combining a convex wafer with a flat or convex barrier ring for added pressure. Samples are often available from manufacturers.

4. Consider convex appliances designed for uneven abdomens:
- Sensura Mio Convex FLIP, with its star-shaped flange, adheres well over raised areas.
- Other convex wafers and belts that apply gentle pressure may help keep the stoma protruding.

5. Create external pressure to keep the stoma out:
- An ostomy support belt, available online, with an opening for the pouch can press the abdomen inward, helping the stoma stay extended.

6. Discuss surgical or medical options if the stoma remains below skin level:
- Re-siting or revising the stoma might be necessary if persistent retraction causes constant pancaking.

7. General tips shared by several members:
- Cover the filter only when ballooning is not an issue.
- Empty the pouch often, drink plenty of fluids, and exercise to keep the output moving.
- Thick output due to adhesions may respond to dietary changes, hydration, or a medical review.