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.