This topic is about dealing with a common issue called "pancaking" that can occur for people with an ileostomy. After 11 years of living with an ileostomy, the person is experiencing this problem where stool collects around the stoma instead of dropping into the pouch. The output is thick, and while small amounts of prune juice have helped, a more lasting solution is needed. Here are some helpful tips and advice shared by others:

1. Reduce friction so stool can slide downward:
- Lubricate the inside of the pouch at every change and as needed during wear. You can use baby oil (liquid or spray-mist), mineral oil, or oil-impregnated sponge stickers.
- After adding oil, swish it around with a little warm water, then drain. Some people find it helpful to raise the pouch under a hernia belt or any abdominal wrap for an hour so the lubricant coats the stoma area.

2. Switch or modify the appliance:
- Try using pouches without filters, as several people report less pancaking when no filter vents the air.
- If using a filtered pouch, cover or tape over the filter.
- Add a small piece of crumpled wet tissue or toilet paper inside the pouch near the stoma to keep the sides from sticking together.

3. Thin the output safely:
- Continue using prune juice, or consider osmotic agents like MiraLAX (polyethylene glycol).
- A generic docusate sodium stool softener, which costs about $4 at Walmart, can be taken once or twice daily. An ET nurse suggests the stool should have a "pudding" consistency.
- Drink extra water and, after each emptying, pour a little water into the pouch to dilute thick output and help rinse it out. This does not harm the stoma.

4. Additional self-help tips:
- Consult online guides such as VeganOstomy’s pancaking article for step-by-step methods.
- Gently massage or "milk" stool away from the stoma if it begins to block.
- If wearing a hernia belt or tight clothing worsens pancaking, try looser support garments or brief periods without the belt when possible.