Note: Updated versions of this article have been published in our February 2009 newsletter and again in our February 2014 issue.
Ostomy newsletters sometimes publish warnings that ostomates, especially ileostomates, shouldn’t donate blood. An often cited horror story concerns an ileostomate who, after giving blood, developed a two-day case of dehydration that couldn’t be relieved by drinking fluids, followed by a kidney stone that developed ten days later.
I am one ileostomate who has always ignored those warnings. I donate blood regularly and haven’t suffered any ill effects. My object in this article is to examine this topic rationally, instead of relying on an anecdote that may be more of an urban myth than an actual event. My conclusion is that most ostomates can probably donate blood without any problem, with one major exception: If your ostomy was done because of cancer (e.g., bowel or bladder cancer), you’ll have to wait 5 years after the surgery until you can give blood.
Of course, since all ostomates are different, and may have a variety of health problems in addition to the ostomy itself, it isn’t possible to make a blanket statement for all ostomates. Therefore, you should check with your doctor if you have any doubts about your ability to give blood.
The question in the title of this article involves two issues: Is giving blood safe for the ostomate? And will the ostomate’s blood be accepted by the blood bank? In researching these issues, I’ve spoken with the head nurse at my local Red Cross blood collection center, and I’ve checked the eligibility guidelines on the American Red Cross website at www.redcross.org.
In my case: As I write this article in August 2006, my lifetime total, so far, consists of 79 blood donations. Of these, a significant majority (at least 48) have been made since my permanent ileostomy surgery in 1992. Prior to that, I donated at least 5 times during the 4 years while I had a J-pouch (my J-pouch failed due to chronic pouchitis and was then replaced by a permanent ileostomy). Before that, I even donated a few times while I had ulcerative colitis, although only during the first few years of the disease, while it was still controlled fairly well.
On the first question, whether giving blood is safe for the ostomate: Dehydration can certainly be a valid issue, especially for ileostomates and others who have lost their colon (including people with J-pouches and Kock pouches), because the colon normally plays a part in absorbing water. Urostomates also need to remain well hydrated to maintain urinary health. Therefore, all of these ostomates should drink extra fluids to stay well hydrated.
Exertion in hot weather can cause serious dehydration, even among non-ostomates (as we know from the heat wave that recently gripped much of the country). For people without a colon, a blockage or gastro-enteritis accompanied by vomiting and diarrhea can lead rapidly to severe dehydration that becomes a major emergency. (In such an episode, it’s essential to push fluids as much as possible, in spite of the nausea. And if the flow doesn’t normalize in about 24 hours, a visit to your local emergency room, for IV rehydration, is in order.)
Compared with the above situations, the dehydration resulting from a blood donation is minor. The quantity of fluid removed (about half a liter, or about one pint) is far less than you’d lose in an acute blockage or gastro-enteritis episode (which may be 5 to 10 times greater). At some blood collection centers, donors are served a quantity of juice or other fluid consisting of about half a liter. So, in principle, you might replace all of the fluid lost in the donation before you’ve even left the center!
In practice, it’s more complicated because ileostomates and others without a colon don’t necessarily absorb all the fluid they drink (i.e., some can pass through the gut without getting absorbed). Therefore, you should drink several times as much extra fluid as the amount removed in the donation. To be safe, drink extra fluids for one or two days preceding the donation to make sure you arrive at the collection center well hydrated. Drink all of the fluids offered to you at the center. Then, continue to drink extra fluids for one or two days following the donation.
With these precautions, you shouldn’t have any problem with dehydration after a blood donation. Still, if you think you’re prone to kidney stones, or if you have any other concerns about the safety of giving blood, check with your doctor.
Turning to the second question, whether the ostomate’s blood will be accepted: Having an ostomy will not, by itself, reject you as a blood donor. Before donating, you’ll need to answer a list of questions, which seems to grow ever longer. Interestingly, I’ve noticed in recent years that none of the questions require mentioning the facts that I have an ostomy or that I had ulcerative colitis. They don’t ask if you have an ostomy. They don’t ask open-ended questions, such as whether you ever had major surgery or if you ever had a serious illness. Instead, the questions are very specific—to check if you have particular health conditions, such as a heart or lung condition, and to check if you might be carrying blood-borne diseases such as HIV/AIDS or hepatitis.
They do ask one question that will catch many ostomates, namely, if you ever had cancer. On this topic, the Red Cross guidelines say: “Eligibility depends on the type of cancer and treatment history. If you had leukemia or lymphoma, including Hodgkin’s Disease, you are not eligible to donate. Other types of cancer are acceptable if the cancer has been treated successfully and it has been at least 5 years since treatment was completed and there has been no cancer recurrence in this time. Some low-risk cancers including squamous or basal cell cancers of the skin do not require a 5 year waiting period.” Thus, if you’ve had bowel or bladder cancer, you won’t be accepted until 5 years after surgery, but you’ll probably be eligible after that.
The 5-year waiting period applies to actual cancer, but not to dysplasia (precancerous changes), which are generally acceptable if treated successfully (e.g., if the dysplastic tissues have been removed). Thus, if dysplasia was found in your colon, but no cancer was found, and the colon has been removed, you should be eligible without any waiting period.
If you currently have a chronic disease such as ulcerative colitis or Crohn’s disease, you’re probably eligible to give blood. Remember: I actually donated a few times while I had ulcerative colitis. If you’ve had an ileostomy due to Crohn’s disease, you still have Crohn’s disease because surgery isn’t curative for that disease. The Red Cross guidelines say: “Most chronic illnesses are acceptable as long as you feel well, the condition is under good control, you have an adequate hemoglobin level and your temperature is normal when you come to donate, and you meet all other eligibility requirements.”
In conclusion, most ostomates are probably eligible to give blood, unless you had cancer and it’s been less than 5 years since surgery. You may, of course, have other health conditions that make you ineligible. But it can’t hurt to try! At the collection center, medical professionals will review your health information, in a confidential setting, to determine if you are actually eligible.
OstomyOK Home
| What is Ostomy?
| Ostomy Care Guides
| Ostomy Supplies
| Newsletter
UOAA Discussion Board
| UOAA Support Groups
| Contact Webmaster
| Search
| Links