I take VSL #3, because that’s what my insurance covers. The products are quite similar, with the current VSL attempting (not completely successfully) to be a perfect copy of the formula now in Visbiome. The effects of probiotics are quite subtle, so it can be hard to tell if you are getting any benefit. For one person to find a meaningful difference between two such similar probiotics would be essentially impossible.

One key difference is availability. VSL #3 is now much harder to find than before the litigation, but I can find the prescription-strength form at Sam’s Club. Visbiome is probably easier to get, though they are still maturing their distribution network.

I was on VSL # 3 for many years cause u needed a prescription for it.  However, it is no longer the case for me and it is way to expensive to afford.  I used to get a 90 supply thru my insurance plan for $15.  So now I get probiotics thru a health food store or on line.  But these alternatives are very expensive.

Rocco

Hi all , I have had my J pouch for 13 months now . The first 6 months were very rough and scary . But I made it and am doing so much better . Had my first J scope a couple of months ago . Showed I had mild pouchitis . This was a surprise to me because I have been going to the bathroom 8 times in a 24 hour period for a very long time with no other systems . I though 8 was very good compared to the 12 - 14 times when I first came home from the hospital . My GI Dr. does not think its good and keeps telling me it should be 4 - 6 times . She had me do 14 days of Mesalamine treatment . I'm down to 6 but still sometimes 8 times in 24 hours . I also do one teaspoon of Metamucial and 4 imodium . I just started on VSL # 3 . To soon to tell if its helping . I spoke to my GI about taking probiotics and all she said was you can try it . She didn't seem to enthusiastic about it or very fourth coming on recommending any or any supplements . My GI surgeon who was Dr. Poylin in Boston relocated to Chicago last year . He was excellent and thought 8 times in a 24 hour period based on what I ate , how many hours apart , and how much I ate that I was doing really well . Now I feel like I'm lost cause I'm not getting much feed back from my current GI Dr.  I want to make sure I'm on the right track and not have the pouchitis get any worse . Anyone has any thoughts it is truly appreciated .  Thank you

I've never had the magic 4-6 a day. More like 8-10 and I think it's just my normal. I'm quite fine with it. (I recently had a scope that didn't show any pouchitis)

Mesalamine doesn’t really do much for pouchitis, as far as I know. You could make a good argument for leaving well enough alone, or for trying 10-14 days of Cipro or Flagyl. Once you start treating problems that aren’t bothersome it’s hard to stop.

Your dose of Metamucil seems too small to have much of an effect. Have you tried following the directions on the package? I’ve used it twice a day for a very long time, and it helps steady things for me.

Counting bowel movements is what GIs are trained to do, but it’s a crappy (pun intended) way to monitor relatively healthy J-pouches (15 or 20 per day is a sign of trouble, of course). Since I don’t have urgency unless I really push it, essentially all of my bowel movements are choices rather than necessities. If I’m heading out a few times during the day I’ll probably choose to use the toilet each time before going out, to avoid discomfort, public restrooms, lousy toilet paper, etc. This isn’t evidence of a pouch problem, but the count goes way up on those days.

Thank you Scott and J.Hendrix   I think your correct Scott the Mesalamine didn't do much and I'm going to increase my dose of Metamucil . Like J I believe that 6 - 8 times a day is my norm . Spoke with  my GI Dr. on Friday she wants me to do a week or two of the Mesalamine suppository and let her know if it decreased to 4 times per day . I don't see that happening and I don't understand why she feels that's is inportant.  I really believe that 6-8 is reallly good for me considering I only have had my J pouch  15 months or am I just being wishful.  Next time I speak to her I'll ask her why she doesn't prescribe the Cipro or Flagyl. Thank you both for your input . It truly helps talking to people who know and understand what I'm talking about and what I'm going through . Take care all , stay safe and be well . I appreciate all your inputs 😊

I’d suggest changing only one thing at a time, so if you experience a change you’ll have a good guess about the most likely cause. So I wouldn’t increase the Metamucil at the same time as making a medication change. Good luck.