Just came back from my colon surgeon and have been on and off cipro and xifaxin for the last 8 months battling pouchitis. My pouch will be 4 years old this March. Never had any issues with the pouch before pouchitis. He recommended trying probiotics with my antibiotics regimen and recommended Flora-Q one cap a day. I've heard good things about the VSL#3, which is more expensive. I'm not sure which to try. This is my first experience with probiotics. Any side effects with the probiotics? Which would you recommend?

Thanks for your advice!

-Sarah

There's two ways to look at it:

1. VSL#3 has the best, and probably only completed studies showing efficacy in sustaining remission in pouchitis. So it would be a good first choice.

2. VSL#3 is very expensive and may not be covered by your insurance. You may find that FloraQ or others may work for you, but you'd never know if you did not try them first.

If it were me, I go with the FloraQ first and give it three months before moving on to another one. But, I am not sure that one a day would be sufficient to keep you in remission if you have chronic pouchitis that is currently antibiotic dependent.

Jan

I have always had the best luck with Culturelle. I've never tried VSL so I can't say whether it's a better choice. I have tried other brands and always come back to Culturelle.

I have taken Culturelle for almost two years. One each morning. Plus I drink one DanActive every evening and two Forvia chewable vitamin / minerals each day.

I have a K-pouch and have not had pouchitis for almost two years.

I find I need a lot of bacteria to make things better. So, VSL has really helped me. I take two DS (double strength) packets a day @ 1800 billion bacteria. Culturelle helped some - but not as much (no surprise).

See if your insurance covers: VSL#3 DS Packets 20's.

I pay a $30 copay for the VSL. If I were to take Culturelle 2x / day it would cost me at least that much each month. With insurance covering it, VSL is actually a more cost-effective option.

There are so many different probiotics. Two Dr. recommended the Flora-Q. I've never heard of the other two mentioned. I started out taking Acidophilus with 100 million live organisms but also ate yogurt. Didn't have pouchitis for little over a year and for 10 yrs always had the ulcers that never completely went away. I think taking the probiotics is what made the difference b/c it was the only change I had made but then found eating yogurt caused me problems so quit eating it. Also couldn't find the probiotic I was currently taking and changed to ultimate probiotic acidophilus with 2 billion and ended up with pouchitis. Flora-Q is a lot more expensive and asked pharmacist about something close to it and was told she has been told there is not another one containing same ingredients. I'm not sure which ingredients helps with pouchitis. The two I have taken on contain lactobacillus but I know the Flora-q contains more. I'm going to check-out other two mentioned on message board but I figure if it keeps me from having pouchitis and not have to take antibiotics its worth every penny. I get 120 tablets for a lot less but then I didn't figure in the yogurt I was also buying.

I take one Culturelle each morning and one small bottle of DanActive in the evenings. Also, I eat non-fat yogurt every morning that is fortified with probiotics. Knock wood - I have had no pouchitis for almost 2 years.

After I posted information I found an interesting website on probiotics. I think it has good information so thought I would post it
www.jonbarron.org/barronreports. After reading this I really believe I got pouchitis again b/c I had stopped eating yogurt in addition to taking probiotics plus I was having additional stress.

VSL#3 has been a main stay for me for several years now. Had my jpouch surgery in 2001. Started with pouchitis right away, occurring about every 3 months. VSL#3 was recommended by by gastro Dr. as a try and see. Very successful. Moved my infections from every 3 months to about once a year. Yes it is expensive. But better that then Flagyl every three months...