If u got the capules then just swallow them with water.  I take 2 at a time 2-3 times a day. If you have the packets then open them and sprinkle or dissolve them in something. I just space my doses equally throughout the day. If you take anitbiotics, make sure you spread the antibiotic dose and the vsl dose far apart as 1 tends to cancel out the other although there is some controversy on this. The pills are more expensive but more user friendly I find than the packets and I feel as if I am getting the full dose this way.

Thanks so much, Hattie!

It's hard to get the higher doses with the capsules. It would take 32 capsules to get my daily dose, if I recall correctly.  Also, if insurance coverage is a possibility for you, only the DS (double strength) packets are ever covered by insurance - they require a prescription. 

One caveat is to NOT take VSL#3 with hot liquids or foods. It will damage the potency. You can take the capsules whole, or open them to mix with food or beverages.

Also, the capsules are quite weak and you need the regular packets of VSL#3 or VSL#3 DS (double strength- prescription only) to deal with pouchitis. The capsules are for minor IBS type things. But, good luck with it anyway. You'd need 4 capsules to equal the strength of one regular VSL#3 packet.

Jan

I've recently started using VSL#3 capsules as well.  My current gastro doc basically said to base my dosage on how I felt as it would be difficult to take too much.  I've also tried to do my research on probiotics and found a recurring theme in the thought that taking a high dose all at once isn't as beneficial as taking a smaller dose spread out during the day.  The thought on this is that especially with a pouch, our bodies naturally flush out more frequently and therefore flush out the good bacteria frequently.  For this reason I've decided to go with the less potent capsules and take them at 3-4 different times throughout the day with food and using a cool beverage rather than something hot, as mentioned above.  This therapy for me seems to be beneficial and is what I chose to address pouchitis rather than suppositories with a pharmaceutical medicine.  I hope you find a benefit soon.

Thanks, all! Lewis, I would actually be *thrilled* if my surgeon would agree to let me try a suppository. Every time I call and beg to try anything other than antibiotics the response is to call in a different antibiotic, and then I take huge steps backwards because antibiotics absolutely destroy me. What suppositories were you taking? Did you find them helpful, even if you didn't care for the delivery method?

J9,   The suppositories I was prescribed were , Canasa (mesalamine, USP) 1000 mg.   I did not try them for very long, and hated every minute when I did.  However, if my pouchitis doesn't resolve with the probiotics I'll have to either use them or enemas.  I have a sigmoidoscopy in a few weeks to determine if I've healed up or not.    In regard to your surgeon not being willing to prescribe these, I would look for a gastro doctor that will.  I've taken so many prescription meds over the years I really don't care to take anymore unless I'm in danger of losing my j-pouch.  I live in a smallish town in Missouri and have had to go to St. Louis and Dallas, TX to get treatment from doctors that were more familiar with my condition.  I hope the best for you and those who are dealing with these issues.  Lewis

Thank you, Lewis! I've asked a few times now if my surgeon would let me try cortifoam, which worked great for me when I still had my colon, and to no avail. I found it much more comfortable than an enema. Maybe something to consider if you find yourself having to consider enemas or suppositories again? I hope your scope goes well!

Best wishes,

janine