In my case VSL3 never made any difference, no side effects, while not improving life with my pouch either.  Can't say I mixed it with Metamucil but I don't see why it would lead to any negative side effects. 

I take them together twice a day, and always have. I think of it as the psyllium providing transportation for the VSL, but who knows?

I'm with Scott. I somehow imagine the fibre helps the  probiotic to reach the bowel. I have nothing to base this on but I like to think it's true. Makes intuitive sense to me though(?)

Great supposition folks! On the contrary I always believed that Psyllium would flush the vsl3 out and not allowing the probiotics to establish in the pouch, SO I always space well the intaking of them. I take the psyllium after meals as a way to provide the fibers I generally don't take during lunch, and Vsl3 in the morning on empty stomach.

But as already said: who knows?

I would suspect that taking probiotics with a fiber supplement would be similar to taking it with a meal. Regardless of how you take it, it would get where it needs to be (there are no detours in our gut). As long as you have a probiotic that is capable of surviving the stomach (strain specific), it should adhere and colonize in the gut.

For whatever reason, those with IBD tend to be less able to colonize with probiotic bacteria. This is why the use of probiotics on a regular basis has been studied for IBD, but results are not consistent. The same is true for j-pouch maintenance. 

So, if VSL#3 or other probiotics don't do what you want them to, don't assume you are taking them wrong (unless you are taking them with hot or carbonated liquids/foods). For some of us, they just don't do anything other than cause gas. 

Jan