Recommendation for | VSL#3 capsules per day | VSL#3 packets per day | VSL#3 DS packets per day |
Dietary management of gas and bloating in IBS | 2-4 capsules | 1 packet | N/A |
Dietary management of ulcerative colitis (UC) | 4-8 capsules | 1-2 packets | 1 DS packet |
Dietary management of active UC | 8-16 capsules | 2-4 packets | 1-2 DS packets |
Dietary management of ileal pouch (pouchitis) | N/A | 2-4 packets | 1-2 DS packets
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The above is from the company web site. The last row is the one to look at (I hope the table show up readably). Elsewhere on their web site, though, they say that up to twice that dose is acceptable, and I do take 4 DS packets daily (in two separate doses of 2 packets). They used to suggest the higher doses (double what's listed above) for active pouchitis, but I don't see that shown explicitly on the web site (the package insert might still show it).
VSL works best at preventing pouchitis. If you wait until symptoms occur it will take quite a while to help, if it helps at all. Since some folks never develop pouchitis, and VSL is expensive, I think it's probably best used after a bout or two of pouchitis (treated with antibiotics), to prevent or reduce subsequent episodes.