Stool donation involves providing fecal matter from a healthy individual for Fecal Microbiota Transplantation (FMT). This procedure is primarily used to treat recurrent Clostridioides difficile infection, a serious intestinal condition causing severe diarrhea and inflammation. The goal of FMT is to restore a healthy balance of gut bacteria by transferring beneficial microbes from the donor’s stool. This reintroduction of a diverse microbial community effectively outcompetes the harmful C. difficile bacteria. The constant need for high-quality donor stool drives the establishment of specialized donor programs and stool banks.
Donor Eligibility and Rigorous Screening
The selection process for stool donors is exceptionally strict, with acceptance rates often falling below 5% of applicants. Potential donors must first complete an extensive health and lifestyle questionnaire to determine preliminary eligibility. This initial review screens for recent antibiotic use, as these medications disrupt the healthy gut flora the donation aims to provide.
Candidates with a history of chronic conditions are typically excluded, including inflammatory bowel disease, irritable bowel syndrome, autoimmune disorders, and most metabolic diseases like diabetes. Donors are also excluded if their Body Mass Index (BMI) exceeds a certain threshold (e.g., 30 kg/m²), due to links between obesity and changes in the gut microbiome. Geographic location and recent travel history to areas with high rates of endemic infectious diseases are significant exclusion factors.
Those who pass the initial questionnaire must undergo comprehensive laboratory testing of both blood and stool samples. Blood is tested for transmissible pathogens, including HIV, Hepatitis A, B, and C, and syphilis. The stool is analyzed for a wide range of bacteria, parasites, and viruses, such as C. difficile, rotavirus, norovirus, and SARS-CoV-2. This extensive and repeated screening ensures the donated material is safe and pure before treating vulnerable patients.
The Practicalities of Collection and Delivery
Donors are typically required to visit a designated donation center, or stool bank, four to five times per week. The donation itself is a time-sensitive procedure that requires careful adherence to specific collection protocols.
Donors are provided with a specialized collection kit, often including a “stool hat” that fits over a toilet bowl to catch the specimen without it touching water or urine. This prevents contamination, which is paramount for maintaining the integrity of the microbial community. The collection must be done hygienically, often involving provided gloves and strict handwashing procedures.
The freshly collected stool must be transferred immediately into a container and delivered to the processing laboratory within a short window, sometimes as little as one hour. This tight deadline preserves the viability of anaerobic bacteria, which die off quickly when exposed to oxygen and ambient temperatures. Centers often provide insulated carriers and ice packs to maintain a specific temperature during transit. For programs that ship samples, the material is rapidly frozen, sometimes mixed with glycerol, and transported using dry ice to maintain ultra-low temperatures.
Compensation and Ongoing Donor Requirements
The commitment required of consistent stool donors is substantial, and programs provide financial compensation for their time and dedication. Compensation covers the time, travel, and effort involved in the frequent collection and rigorous screening process, not the product itself. Centers may offer a set amount per successful donation, often around $40 to $50 per sample.
This frequent donation can translate into earning up to $1,500 per month for donors who consistently provide four to five samples weekly. Some specialty programs seeking donors with exceptionally rare or high-quality microbiomes may offer significantly higher compensation, sometimes up to $500 per sample. Donors must commit to a donation schedule for several months to ensure a reliable supply of material.
To remain active in the program, donors must undergo periodic re-screening to confirm their continued health and the safety of their stool. This typically involves repeating blood tests monthly and providing new stool samples for pathogen testing every few weeks. Any change in health status, medication use, or travel must be immediately reported, as it could temporarily or permanently disqualify the donor.