Skip to main content

Hi I have never attempted to post a new question before so hopefully this will work.

I have been prescribed VSL#3 by my GP at the request of my pouch nurse but I am unsure how much I should be taking and when. The strength is 450 billion bacteria per sachet ( I am not sure if there are different strengths) and each sachet is 4.4g. 

I am currently still taking Cipro and Metronidazole (I think this is Flagyl in the U.S.). Should I wait until I finish these, which will be another 4 weeks, before starting the VSL#3 ?

I will be grateful for any advice.

Original Post

Replies sorted oldest to newest

I'm sorry I don't have any advice I've purchased some align probiotics a months worth and I haven't even touch them yet I've heard to takes weeks to get into your system and may cause more BMs before it gets better I'm kinda clueless myself and I have a type a nurse that says yes to everything I mention .. I can tell her if I stand in front of a speeding train and it hits me will I have less BMs her reply would be .. Yea yea try it ! Lol 


You have the Single Strength sachets. The maximum dose is 8 of those daily, which adds up to real money. I take the maximum dose, as two Double Strength (DS) sachets (900 billion bacteria each) with breakfast, and two more with dinner. 

Figuring out the correct dose is tricky, since VSL mostly prevents problems, and it takes a long time to figure out whether optimal prevention has occurred. A reasonable starting dose might be half what I'm taking (4 SS sachets daily), or even a bit less, if the cost is a problem.

Antibiotics make VSL less effective, and some (but not all) doctors just suggest not bothering with it while on antibiotics, while others suggest increasing the dose. I am on antibiotics all the time, so I'm clearly in the "take them at the same time" camp.

You might experience some gassiness when you first start. For most people this passes after a while.

Good luck!


I took 2 double strength VSL3 packets per day. Each in apple sauce or a chocolate breakfast shake due to the taste for me.  That's what I could afford but should have been taking more most likely.  I think it helped some and it does work for many. However, I was just too far gone and it didn't help me much.  I still believe in probiotics a great deal.  I took mine with antibiotics also.  Good luck and I hope this helps.  

I have had my pouch since 2010, and in the past couple of years have had recurring issues with pouchitis. I had previously tried VSL #3 DS but it seemed to make my symptoms worse, so I stopped. Fast forward to two months ago: I had a particularly bad bout of pouchitis so my doc prescribed Cipro 2x daily and Flagyl 3x daily for a month. These gave me horrible stomach cramps and tendonitis, so I tried the DS again, starting with one pouch per day. I did this for about a week, then increased to two. I now take 2-4/day depending on how I'm feeling. It does take a while for your body to adjust at first, but stick with it! I feel great now, very little gas, I almost never get bloated, and I have stopped taking Imodium and Welchol as I found I just didn't need them. Hoping this continues long term. Good luck!

Add Reply

Copyright © 2019 The J-Pouch Group. All rights reserved.
Link copied to your clipboard.