Let's talk about a common issue that some people with an ostomy might face, known as "pancaking." This happens when stool stays around the stoma and doesn't slide down into the pouch as it should. If you're dealing with this, here are some practical tips that might help:

1. Try switching to a different pouch style. Some people find that pouches without a filter work better because they prevent air loss, which can cause suction and lead to pancaking.

2. Consider irrigation if it's suitable for your anatomy and stoma size. This method can provide a more predictable and complete emptying, which might eliminate the pancaking issue.

3. Increase your fluid intake. Aim for about 5-6 pints (approximately 2.5–3 liters) of water, juice, coffee, tea, or even beer each day. This can help your output move more smoothly.

4. Use a manual top-opening clean-out method:
- Opt for a two-piece system with an adhesive coupling.
- When you feel pressure building, unseal the top, clean away the stool with toilet paper, and then reseal it.
- Keep the stool firm for easier removal.
- Be careful not to touch the adhesive on the flange with toilet paper to maintain its effectiveness.

5. Firm up your output through diet or medication:
- Foods high in non-soluble fiber, like oatmeal, bananas, and mango, can help.
- With your surgeon's approval, you might try taking 1–2 tablets of Imodium (loperamide) at bedtime, and an extra tablet during the day if needed. Just be aware that it might cause drowsiness.

6. If your stool is too thick for irrigation or manual removal, especially if you have a very small stoma, you might need to take the opposite approach. Using doctor-approved laxatives can help thin the output and reduce pancaking.

These suggestions are meant to help manage or prevent pancaking, making life with an ostomy a bit easier.