Managing Pancaking and Appliance Changes After Gallbladder Removal

Question:

Hello,

I have had my stoma for five years as a result of cancer.

On January 8th, I had my gallbladder removed and was hospitalized for a week, followed by two weeks of IV antibiotics. Since then, I have been eating smaller meals (4-6 per day), but my stomach is very active, and I am experiencing significant pancaking. As a result, I am changing my bag and flange 4-5 times a week.

I drink 2-2.5 liters of water per day, and before this surgery, I had minimal issues with my stoma.

I am wondering if someone can help me find a solution. I live near London, Ontario.

Answer:

You have been through a lot, and it’s understandable that you’re looking for solutions. Gallbladder removal affects digestion, particularly how the body processes fats. This can lead to changes in bowel consistency, sometimes making output drier or more pasty, which could be contributing to the pancaking you’re experiencing.

Here are a few things to consider:

1. Diet and Fat Absorption
   • Without a gallbladder, fats move through the intestines differently, sometimes causing thicker stool.
   • You may benefit from adding healthy fats to your diet, such as omega oils, which support both overall health and bowel function.
   • Have you changed your diet since surgery? Many people tend to eat softer, carb-heavy foods (e.g., pasta, bread, flour-based foods) during recovery, which can thicken stool and contribute to pancaking.
2. Stoma Behavior and Appliance Fit
   • Does your stoma pull in when active? If so, this could affect how the output flows into your pouch.
   • Consider if there is a pattern between when you change your appliance and when your bowels move. If changes align with heavier bowel activity, adjusting your timing might help.
   • Have you tried a different pouching system? Sometimes, a temporary change in appliance can improve function while your body is still adjusting post-surgery.
3. Managing Pancaking
   • A pouch lubricant can help stool slide down more easily, preventing it from sticking near the top of the pouch.
   • Increase fluid intake if needed, as thicker stool can contribute to pancaking.
   • Some people find that gently inflating the pouch with a small amount of air before applying it can reduce pancaking by keeping the inside of the pouch from collapsing.
4. Professional Support
   • Since you are in your 8th week post-surgery, you will likely have a follow-up with your surgeon soon, which is a good opportunity to discuss these changes.
   • A consultation with an NSWOC (Nurse Specialized in Wound, Ostomy, and Continence) could provide guidance on adjusting your appliance or troubleshooting changes in your stoma function.
   • A nutritionist or your physician may also be able to advise whether adding omega oils or making dietary adjustments could help regulate your bowel function.

I hope this information helps as you continue your recovery. If you have the opportunity to speak with an NSWOC or nutritionist, they may be valuable resources in finding a long-term solution.

Answered by:

Teri
Nurse specialized in Wound Ostomy and Continence

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