Ballooning

If you have a stoma, you may have already come across ballooning - or you might be reading this because it has started happening with your stoma bag. Either way, you are not alone. Ballooning is a challenge for some people living with a stoma, and whilst it can be inconvenient and sometimes embarrassing, it is almost always manageable once you understand what is causing it.

In this guide, we explain what ballooning is, why it happens, and what you can do to reduce it - from simple dietary changes to finding the right stoma bag for your needs. We also cover when it is worth speaking to your Stoma Care Nurse for extra support.

What is ballooning?

Ballooning occurs when your stoma bag blows up with wind. This is usually due to the filter becoming wet or blocked from stoma output. This can cause the bag to come away from the body.

Please note: Stoma ballooning can happen with a colostomy or occasionally with an ileostomy.

What is the difference between ballooning and pancaking?

Ballooning and pancaking are two separate issues that people living with a stoma may experience.

As explained above, ballooning is caused by a build-up of wind inside the bag, making it blow up with wind. Pancaking is a different issue - it is caused by a negative vacuum within the stoma bag, due to no wind or air being present in the bag, therefore, stool collects around the stoma, pushing the bag away from the skin and causing it to lose its seal and leak. When this happens, the stool in contact with the skin can cause irritation.

If you are unsure whether you are experiencing ballooning, or pancaking, your Stoma Care Nurse will be able to help you identify what is happening and suggest the right solutions.

Why does my stoma bag keep ballooning?

Wind in the digestive system is completely natural. However, when you have a stoma, that wind has nowhere to go except into your stoma bag. If the bag's filter is not working properly because it has become wet, is blocked with output or has been covered, the wind can build up inside rather than being released gradually.

Ballooning tends to be more common with a colostomy, as the output from the colon contains more gas. It can also happen with an ileostomy, though this is less frequent.

How to prevent ballooning

If you are experiencing ballooning you could try implementing the following tips, which may help:

If you are using a filter cover, try removing it. The next thing is to consider your fluid and dietary intake:

• Spicy foods, some vegetables (onions, cabbage, peas, and beans) and fizzy drinks have been known to increase wind, so try to avoid these
• Avoid drinking with your meal as this can cause you to swallow excess air.
• Eating regular meals will reduce the build-up of wind.
• Avoid chewing gum and smoking cigarettes and vapes, as both these activities increase the amount of air we ingest.

Which foods can help reduce wind with a stoma?

As well as knowing which foods to avoid, it helps to know what to include in your diet. Foods that are generally easier to digest and less likely to cause excess wind include:

• White rice, pasta, and bread
• Cooked vegetables such as carrots, courgettes, and potatoes
• Lean meats, fish, and eggs
• Natural yoghurt, which may help to support gut bacteria.

Everyone's digestive system is different, so it is worth keeping a food diary to track which foods trigger ballooning for you personally.

Please note: If you continue to have ballooning issues with your stoma bag, you should contact your Stoma Care Nurse for further advice and support.

What should I do when my stoma bag starts to balloon?

If your bag begins to balloon, there are a few steps you can take straight away:

• Find a private space, such as a toilet cubicle, to release the gas safely.
• If you have a drainable bag, open the outlet to release the air.
• If you have a closed bag, change the bag promptly to avoid it becoming too full and being pushed away from the body, which could break the seal and cause a leak.

Can choosing the right stoma bag help with ballooning?

Yes - the type of stoma bag you use can make a real difference. Most modern stoma bags include a charcoal filter that releases gas slowly and discreetly. However, filters can become ineffective if they get wet during bathing or swimming, or become coated in stoma output.

At Salts Healthcare, our Confidence BE range is designed to help manage wind discreetly. If you are regularly experiencing ballooning, it may be worth exploring our Confidence BE range to find a product that suits your lifestyle and output type.

With some filters, you may also want to consider using filter stickers or covers at times when the filter is likely to get wet - for example, during swimming or bathing - and removing them once you are dry to restore the filter's function.

When should I contact my Stoma Care Nurse about ballooning?

Occasional ballooning is normal and manageable for most ostomates. However, you should get in touch with your Stoma Care Nurse if:

• Ballooning is happening frequently, despite dietary changes
• You are regularly experiencing leaks caused by ballooning
• You are struggling to identify a trigger and need personalised dietary advice

Your Stoma Care Nurse is there to support you and can recommend specific products, dietary changes, or refer you to a dietitian if needed. Do not hesitate to reach out - managing ballooning is a very common reason ostomates seek support.

Top tips to help reduce stoma bag ballooning

Below you will be able find a video to help you reduce ballooning. These top tips to help reduce ballooning have been provided by Debbie Smith. Debbie is a Clinical Nurse Specialist at Salts Healthcare.

Watch the video here: