This topic is about finding ways to manage some common challenges faced by people with a new ileostomy, specifically dealing with "pancaking" (where output sticks around the stoma) and the build-up of stool at the top of the pouch during the night. These issues can make it difficult to get a good night's sleep, as the pouch often needs to be emptied every 1–2 hours. The person is hopeful that these problems will improve over time and is seeking practical advice.

Here are some helpful tips and insights:

1. Cutting & Sizing
- Ensure the wafer hole is not too tight around the stoma, as this can worsen pancaking.
- Use pre-cut flanges or a measuring card to get the opening as close to the stoma size as possible.
- Fill any gaps with rings like Hollister Adapt Rings or Eakin Cohesive Seals, which many find more effective than paste.

2. Pouching Systems & Accessories
- Consider Coloplast 1-piece and 2-piece Convexity systems, which have been effective for others, lasting up to 5 days without leaks.
- Eakin Small Seals can be molded slightly inside the wafer hole and warmed to improve adhesion.
- High-volume or large-capacity drainable bags can reduce the frequency of night-time emptying.
- Use lubricants such as Hollister Adapt Lubricating Deodorant, baby oil, or cooking spray to help stool slide down more easily.

3. Diet & Fluids
- Avoid eating 2–4 hours before bedtime to reduce night-time output.
- Opt for 5–6 small meals instead of 3 large ones.
- Be cautious with foods that thicken output, like bananas and rice, especially at night.
- Stay well-hydrated to prevent thick output, which can lead to pancaking. Drinks like Gatorade G2 and Ocean Spray Light Cran-Raspberry are recommended.
- Some people use Imodium (loperamide) to slow down output.

4. Night-Time Routine
- Always empty the pouch before lying down, and if you wake up sensing it's filling, empty it immediately to get back to sleep faster.
- Avoid large fluid intakes right before bed.

5. Skin & Seal Care
- Use LBF (Barrier Film) wipes to protect the skin and help with wafer adhesion.
- Holding your hand over the wafer for about 10 minutes after application can warm the adhesive for a better seal.

6. Professional Support
- Consider booking an appointment with an ET/WOC nurse to reassess stoma size, appliance fit, and accessory choices, which can save time and reduce frustration.

7. Resource
- A free booklet of ostomy tips is available from the Bayonne Ostomy Alliance, which can be a helpful resource.

8. Encouragement
- It's common for output patterns to settle over time, and many people experience fewer night-time empties after the initial months.
- Remember that finding the right solution may take some experimentation, but you will get through it.