This topic is about someone experiencing a common issue known as "pancaking" with their ostomy pouch, which started after they added soft lettuce leaves back into their diet. Pancaking happens when stool collects under the flange, often causing discomfort and potential skin irritation. The person is trying to figure out if the lettuce is causing this problem or if they need to adjust their diet or ostomy care routine. Here are some helpful insights and advice:

1. Body Position: Try to avoid sleeping or lounging on the side where your stoma is located, as this can encourage pancaking. Keeping weight off that side might help.

2. Flange Opening: Make sure the opening around your stoma is not too large. A snug fit can prevent stool from seeping underneath and causing pancaking.

3. Pouch Lubrication: Consider using a product like Hollister 78500 deodorant inside the pouch. This can help reduce odor and allow the output to slide to the bottom more easily, which might minimize pancaking.

4. Type of Lettuce: The type of lettuce you eat can make a difference. Iceberg or romaine lettuce, which are lower in fiber, might be easier on your system compared to red or green leaf varieties.

5. Consider a Convex Wafer: If your abdomen is rounder, a convex wafer might provide a better seal than a flat one, potentially reducing pancaking.

6. Consult a Nurse: It might be helpful to temporarily stop eating lettuce and consult with an Enterostomal Therapy (ET) nurse for personalized advice.