King's College London

Scientists have begun work to create a bagless stoma – otherwise known as a colostomy bag – which could transform the lives of people living with the effects of bowel disease.

In the UK today, more than 100,000 people are living with a stoma and 13,000 people undergo stoma surgery (a colostomy) every year. People with a stoma bag will either have it temporarily or for the rest of their life and while some live happily with a stoma, most would love to be able to live without it.

A device without a bag could revolutionise how people live with a stoma and researchers at King’s College London have secured funding to begin working on a concept design.

Stoma surgery is a way of diverting waste from the digestive system into a bag on the outside of the body. The surgery is used to treat a variety of illnesses –including cancer and abdominal trauma, but also Inflammatory Bowel Disease, including Crohn’s disease and ulcerative colitis for which there is no cure.

While stoma surgery is often life-saving, having a stoma bag can make life complicated. Emptying and changing the bag throughout the day, ensuring it doesn’t move out of place or leak and taking care to avoid irritating the skin around it means the wearer is constantly reminded they have a stoma bag. For many people, this can leave them unable to exercise, socialise or work.

Development of the bagless stoma device at King’s is being pioneered by Dr Carlo Seneci, whose PhD subject was the design and manufacture of surgical robots. The project is being led by Christine Norton, Professor of Clinical Nursing Research and is being funded by King’s College London.

Looking a bit like a flashing belly button or something from a plumber’s toolbox, the stoma device is a five centimetre wide plastic device created by a 3D printer. The idea is that it will be implanted into the abdomen. Smart sensing and flashing lights will warn the wearer when it is full and a mechanism will enable the wearer to empty the contents when they choose.

The research is being supported by the Patient and Public Involvement programme of the charity Bowel & Cancer Research. A group of ostomates - people with stoma bags – are discussing with the research team about what the device would need to do for it to be a viable alternative to using a stoma bag.

Ostomate Lesley Booth, 58, who was fitted with a bag in 2016, said the device could change her life. ‘Having a stoma is like living with a hot water bottle strapped to your front which fills up constantly. When you roll over at night, the whole thing squidges. To be able to not worry that it might pop or leak, to wear clothes that aren’t smocks, and to feel sexy again would be life-changing. It would mean I was in control. I’d get my body shape back. When travelling, I’d feel more normal than someone wearing a bulging bag which could leak at any time.’

Professor Norton explains the research is in its early stages: ‘We don’t know if we can make this work – our early prototype is still a long way down the line. But it’s a start. We have seven stoma-wearers helping to define the basic requirements and there is lots of enthusiasm for the concept. We want it to be smart, easy to empty and able to vent gas. Some patients have requested a tattoo to hide what will look a bit like a flashing belly button. If we have proof of concept and a proper prototype, we’ll seek further funding for something which has the potential to transform the lives of thousands of people.’

Dr Carlo Seneci said: ‘It is a great privilege to work in a field that allows you to directly help people if your research is successful. We have a fantastic multidisciplinary team of people with experience in medicine, nursing and engineering. Together with the support and enthusiasm of Bowel & Cancer Research and their patient groups, we hope to be able to help thousands of people with our device.’

Chief Executive of Bowel & Cancer Research Deborah Gilbert said: ‘Living with a stoma is a reality for many thousands of people with bowel disease. A stoma can be a life-saver and provide release from the misery and pain caused by chronic bowel disease but that’s not to say that there isn’t a great deal of room for improvement in design and wearability. We are therefore very proud to be supporting this research as part of our Patient and Public Involvement programme.’

If successful, the bagless stoma would provide untold relief to tens of thousands of people who face having a stoma bag attached to their stomach for the rest of their lives.