Pancaking is a common problem for people with an ostomy, where stool collects around the stoma opening instead of dropping to the bottom of the pouch. The waste stays bunched up near the top, pressing against the skin and the baseplate, which can cause leaks and skin irritation. It’s one of the most frequently discussed ostomy challenges, and fortunately, several simple fixes can prevent it.
How Pancaking Happens
An ostomy pouch has a built-in filter that lets gas escape while neutralizing odor. The problem is that when the filter works too efficiently, it removes nearly all the air from inside the bag. This creates a vacuum effect where the front and back walls of the pouch suction together, leaving no space for stool to travel downward. The waste has nowhere to go, so it pools right at the stoma opening and spreads outward against the adhesive barrier.
Tight or form-fitting clothing can make things worse. External pressure flattens the pouch against the body, physically preventing stool from moving down even if there is some air inside. Thicker stool consistency also plays a role, since firmer output doesn’t slide as easily as looser waste.
Why It Matters for Your Skin
Pancaking isn’t just an inconvenience. When stool sits against the skin around the stoma, it causes irritation and breakdown over time. Research published in the WCET Journal found that ileostomies with pancaking had 2.4 times more skin irritation than those without pancaking, a difference that was statistically significant. Even among colostomy patients, who generally experience less skin trouble, pancaking increased the risk of irritation from stool contacting the back of the skin barrier. Beyond soreness, the buildup of waste near the baseplate can compromise the seal, leading to leaks that damage skin further and require more frequent pouch changes.
Covering or Taping the Filter
The simplest fix targets the root cause: the filter pulling too much air out of the pouch. Many pouch manufacturers include small adhesive stickers designed to cover the filter during activities like swimming, but these same stickers work perfectly for preventing the vacuum effect during everyday use. A small piece of medical tape over the filter does the same job. With the filter partially or fully covered, enough air stays in the bag to keep the walls apart, giving stool room to drop.
Some people cover the filter only at night, when they can’t adjust the pouch as easily and pancaking is most likely to cause a leak. Others keep it covered full-time and simply burp the pouch manually when gas builds up. The trade-off is that you lose the hands-free gas venting, but for many ostomates, avoiding pancaking is well worth it.
Lubricating the Inside of the Pouch
Adding a small amount of lubricant inside the bag helps stool slide downward instead of sticking to the walls. The most popular options among ostomates are baby oil and olive oil, applied with a quick squirt into the top of the pouch before closing it. Purpose-made ostomy lubricating deodorants combine the slippery coating with odor control in one product.
Some people get creative with alternatives. A few drops of peppermint or eucalyptus essential oil mixed into a carrier oil like vegetable oil serves double duty as both lubricant and deodorizer. Others have found that antibacterial hand gel, which is inexpensive and easy to carry, provides a similar slick coating inside the pouch. Whatever you use, the goal is the same: reduce the friction between stool and the pouch walls so gravity can do its job.
Other Practical Adjustments
Blowing a small puff of air into the pouch before sealing it creates an air cushion that keeps the walls separated. This is especially useful when combined with a covered filter, since the air you introduce will stay trapped inside. Some people fold a small piece of toilet tissue and place it loosely inside the pouch to act as a physical spacer between the front and back walls.
Clothing choices matter too. Switching from tight waistbands or compression garments to looser fits around the abdomen gives the pouch room to hang naturally. High-waisted pants or skirts that press directly over the stoma are common culprits. If you prefer fitted clothing, wearing an ostomy belt or support garment that holds the baseplate in place without flattening the pouch itself can help.
Stool consistency is the other variable you can influence. Staying well hydrated and eating foods that produce slightly softer output makes waste less likely to stick at the top of the bag. This is more relevant for colostomy patients, whose output tends to be firmer than ileostomy output. Small dietary shifts, like increasing fluid intake or adding foods that loosen stool slightly, can reduce how often pancaking occurs.
Finding the Right Combination
Most people who deal with pancaking find that no single fix eliminates it entirely. The combination that works best depends on your type of ostomy, your typical output consistency, and the specific pouching system you use. A common starting point is covering the filter and adding a lubricant, which together address both the vacuum effect and the friction problem. From there, you can experiment with air cushioning, clothing adjustments, or dietary changes until pancaking becomes rare rather than routine. Switching to a different pouch brand or style, particularly one with a different filter design or a more flexible front panel, is also worth trying if the simpler fixes don’t get you far enough.