i want everyone who reads this to give me an opinion please. should probiotics be started right after takedown or should i just delay and see if i would need them? should i just be safe and start taking them after? what is the protocol? regarding VSL#3, if i decide to take probiotics, should i start with regular strength and if needed go with the DS.? or do people just start the DS first?

Does anyone know: has anyone studied this (i.e., started two groups of patients on probiotics and placebo immediately after takedown and then followed who got pouchitis and who didn't)? If they have, it was a really small study. Can't quite recall at the moment whether I actually saw one or just thought that it would be a good idea.

I asked my surgeon (at Mayo) about it before my takedown (last week) and he said: "Well, I don't really recommend it, because it's expensive and only half of you will ever get pouchitis anyway." He seemed to regard it as overkill, but wasn't actually against it.

I started one packet of single-strength VSL a day this week. If I haven't gotten pouchitis by then, I will ask my GI for an Rx for the double-strength next time I see her (in September), at which point it will be a lot cheaper (because of my Rx coverage).

So, that's what I'm doing. But I can't really call it advice because--see above--I'm not sure anyone's really investigated this using, you know, science.

PS I picked VSL because, as a "medical food", it doesn't fall under the nonregulations of DSHEA:

http://en.wikipedia.org/wiki/Dietary_supplement

Many other probiotics, though less expensive, are classified as dietary supplements and therefore aren't held accountable by the FDA to contain what is listed on the bottle. "Medical foods" are only marginally better--neither of them is as well-regulated as things that are classified as "drugs"--but in my mind, this was a reason to skip the cheaper options and go right to the VSL.

I have been taking probiotics for over 30 years, long before I was diagnosed with UC. You can start taking them at any time. I don't think you need to hit the ground running with VSL but try some of the less costly ones. Culturelle is a readily available probiotic and gets good marks from Consumer Labs on its efficacy.

Sue

can amyone else weigh in on this as to when to start probiotics? right away or just wait and see if i need them?

Started Culterelle on my own about 3 weeks post takedown. I am 9 months past takedown and have not had pouchitis. I also eat an Activia yogurt every day, although I've been a little lazy on that here in the last couple weeks. I figured the Culterelle won't hurt me and I would rather be safe than suffer.

nys

My daughter's surgeon said to start as soon as possible after takedown so that's what she did. It's 2 years later and she's doing great. I think I replied to you on another post regarding this, but she started with the regular strength but recently switched to the double strength to save $ since insurance would pay for the double strength but not the regular strength.
Here are a couple of links for you to read up on some of the studies. Hope these help!

http://www.vsl3.com/VSL3/research.asp
http://www.ncbi.nlm.nih.gov/pubmed/14684584
http://findarticles.com/p/articles/mi_m5LWU/is_8_12/ai_n25122096