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.