I have used VSL #3 for about 12 years. I think it helped delay my need for long-term antibiotics by about a year, and it still helps me. Unfortunately it seems to work best at higher doses, and it’s very expensive at those doses. At my current dose (I use the double-strength packets) a bottle of 60 capsules would last less than 2 days. Many people use lower doses. It can be hard to tell if it’s working. It’s not a good alternative to Cipro or Flagyl, but it can reduce the frequency of pouchitis for some folks.

Some insurance companies will cover the prescription-strength DS packets. Mine does, but I had to fight with them for about a year to get it covered.

Hi Scott---I just posted some info in the general discussion forum about alternatives to VSL#3, since I, too, find it very expensive. I have been trying several approaches to keeping my gut calm and not inflammed: (1) Low FODMAP diet, which has been shown to dramatically help people with irritable bowel syndrome; (2) taking some form of probiotics (I do Nancy's yogurt with its billions of cultures and eat it for breakfast several days a week and I take oral PB8, a capsule with probiotics, 2 times a day); and (3) taking Dysbiocide and FC Cidal, which were shown to be as effective as an antibiotic in addressing SIBO (a condition of bacterial overgrowth in the small intestine). The Dysbiocide and FC Cidal are cheaper than VSL#3. So, my overall approach these days is to make sure I am not disturbing my gut by eating wisely (Low FODMAP), adding some good bacteria, and trying to reduce the bad bacteria. I have been doing this for a about 4-6 months now with pretty good results. Hope this is helpful to you. 

what is low FODMAP?