Tulsamom, I’ve been getting good results from VSL for about ten years. I was able to persuade my insurance company to cover the DS version, but it was a year-long fight. My sense is that it’s quite close to the Visbiome formula that actually was tested in all that research, but VSL is, apparently, a counterfeit. It’s a high-quality counterfeit, though. I’m staying on the VSL because 1) it works for me, 2) the formula is quite similar to Visbiome, and 3) my insurance company’s policy names VSL specifically, so they almost certainly wouldn’t cover Visbiome.

The capsules and the powder are identical products. The cost per CFU (live bacterium) seemed quite similar among the forms when I compared them some years ago. Dose definitely matters for me - I take a lot: 4 DS packets daily. When I lower the dose I find increased symptoms. I’d have to take 32 capsules daily to get the same dose.

If you have pouchitis VSL alone is probably inadequate to treat it. You’d probably be more successful getting it under control with antibiotics, and then maintaining with VSL.

Thank you Scott! I'm not using it for pouchitis. Just to give my system some stability so it doesn't change constantly and destabilize so often. Plus the benefits for psychological health, hopefully. I found a research paper stating that the Italian made VSL had a slightly different effect than the VSL that used to be made in the US with the original formula. It probably wouldn't make any difference to most people. And if I were you, having insurance coverage of it, I wouldn't change either.

VSL3# capsules or the DS sachets are considered to be top notch probiotics specially for patients with IBD or jpouch. 

I used to take 1 capsule a day for a month after my first surgery. The effects were not very visible as nothing changes the ostomy outputs too much. Post takedown I only took only one probiotic strain i.e. lactic acid basillus. Then I bought a low strength probiotic from garden of life with a strength of 25 million. I took it for sometime irregularly and saw no visible change on the pouch or the ouput. 

Very recently I took VSL3# capsules again and I got severe gas and bloating. I needed body to get adjusted to it. But the gas and cramping was so much, I had to quit it within 3 days of use. 

Now I am going to try taking one tablet on alternate days to lessen the effects and slowly go upwards. 

FWIW, here is what the VSL folks are saying about the litigation with the Visbiome folks: https://www.vsl3.com/assets/v1...tter_CourtRuling.pdf

I've been living with a S-pouch for 34 years just a handful of pouch flare ups during that time, still everyday there are reminders how adnormal it is to live with this type of procedure. I my case it's been a testament of patience and resolve .  I found VSL to be a great addition to help with any kind of imbalance in the gut. Its great to see.the growth in awareness for gut health.. 

One would think the jury verdict would have served to knock down the retail cost of VSL#3. True?

The price of VSL fluctuates a bit, at least at CVS, but most recently it’s gone up.