Stool donation, also known as Fecal Microbiota Transplantation (FMT), involves transferring stool from a healthy individual to a patient. This process aims to restore a balanced community of microorganisms within the recipient’s gut. The donated stool, rich in diverse beneficial microbes, can improve the health of a diseased colon and is also utilized for medical research.
Why Stool Donation is Needed
Stool donation is primarily needed to treat recurrent Clostridioides difficile infection (CDI), a severe gastrointestinal condition. Antibiotic use often triggers CDI by disrupting the natural balance of gut bacteria, allowing harmful C. difficile to flourish. While antibiotics are typically used for initial treatment, many patients experience recurring infections, making FMT a promising solution.
FMT works by introducing healthy bacteria from a screened donor into the recipient’s intestine, restoring microbial balance and preventing C. difficile overgrowth. Studies show FMT is over 85% effective in treating recurrent CDI where antibiotics have failed, significantly higher than the 30-40% success rate of antibiotics for recurrent cases. Beyond CDI, FMT is being explored for other conditions linked to gut dysbiosis, such as inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS), though its efficacy for these conditions is still under investigation.
Who Can Donate
Becoming a stool donor involves a rigorous screening process because only a tiny fraction, potentially fewer than 0.1%, of applicants qualify. Donors must be in exceptional physical and mental health, ideally young adults under 30, though some programs accept individuals between 18 and 48 years old. Potential donors are typically excluded if they have taken antibiotics or probiotics in the six months prior to donation, or if they smoke more than 10 cigarettes daily.
The screening begins with a comprehensive health questionnaire covering health status, occupation, disease history, medication use, family history, and infectious disease risks. This is followed by a clinical evaluation and a video interview. Donors should have regular bowel movements and maintain a normal weight, typically with a Body Mass Index (BMI) between 18.5 and 28 kg/m².
Extensive blood and stool tests are performed to screen for various pathogens, including Hepatitis A, B, and C, HIV 1 and 2, HTLV 1 and 2, syphilis, Clostridioides difficile, parasites, and other infectious bacteria like E. coli O157:H7. Donors with a history of chronic diarrhea, inflammatory bowel disease, or colorectal cancer are generally excluded. The strictness of these criteria is to ensure the safety of both the donor and the recipient, preventing the transmission of any infectious diseases or undesirable conditions.
The Donation Process
The journey to becoming a stool donor typically begins with an online questionnaire to assess initial eligibility based on broad health and medical history questions. If this initial screening is successful, candidates are usually invited for a phone interview with a program specialist to further evaluate their suitability.
Following the phone screening, prospective donors provide initial stool samples at a donation center. These samples undergo extensive testing to identify the presence of desired microbes and rule out pathogens. If these tests are satisfactory, the individual is approved to become a regular donor.
Actual donations typically occur frequently, often 4 to 6 times per week, at specialized donation centers or sometimes through home collection kits. Donors collect their stool into a provided container, complete a short health questionnaire, and then deliver the sample. The entire process at a center can take around 20 minutes. For home donations, a driver collects the sample from the donor’s residence, providing a new kit for the next donation. Donors are expected to commit for at least six months, with routine blood and stool re-screenings performed approximately every 30 days to ensure continued eligibility and safety.
Donor Compensation and Impact
Stool donors typically receive financial compensation for their contributions, which is considered a reimbursement for their time, effort, and any inconvenience. While not a salary, this compensation can range from approximately $40 to $100 per sample. Frequent donors, contributing multiple times a week, can earn between $500 and $1,500 per month. Some programs offer higher amounts for exceptional quality, with certain donors receiving up to $500 per sample.
The impact of these donations extends beyond the financial benefit to the donor. Stool donations enable Fecal Microbiota Transplants for patients suffering from severe recurrent Clostridioides difficile infections, a condition that can be debilitating and even fatal. Donor contributions also fuel ongoing medical research into the gut microbiome, potentially leading to new therapies for a wider range of conditions, including various gastrointestinal disorders and neurological diseases. Donors often report being motivated by the desire to help patients and contribute to scientific advancements, recognizing the difference their donations make in improving health outcomes.