Chronic pouchitis has been helped by the probiotic VSL #3.
Two trials totaling 76 patients who were already in remission were given either VSL 3 or a placebo. At the end of the 9 month trial, 85% of people who had been given the probiotic therapy had remained in remission whilst ALL of the people on the placebo had relapsed. When the probiotic blend was withdrawn at the end of the trial ALL patients who had so far remained in remission relapsed.¹
You can buy VSL #3 online here. VSL 3 capsules for ulcerative colitis
A similar but independent trial extended for one year, again this is in people who were in full remission, and again at the completion of the trial 85% of the VSL3 group were still in remission whereas only 6% of the group on placebo were.²A more recent study backed up these findings with the conclusion: "Our data demonstrate that the probiotic VSL#3 alters the composition of the intestinal microbiota and these changes correlate with VSL#3-induced disease protection."5
A trial of 40 patients who had undergone ileal pouch-anal anastomosis was conducted with people receiving either VSL3 (900 billion colony forming units a day) or a placebo AFTER one month of antibiotic therapy.
90% of the people taking the probiotic had an endoscopically normal pouch and were symptom free after one year. Their conclusion was that treatment with VSL3 is effective in the prevention of the onset of acute problems and improves quality of life of patients with ileal pouch-anal anastomosis.³
Although antibiotic therapy is often effective, between 5 to 15% of folk with an IPAA created for ulcerative colitis will experience chronic problems. A once daily high dose of VSL#3 (6g daily) has kept patients in remission for at least a year according to one study.
Recommended daily intakes for adults is on the VSL3 page but these are an indication only and you should follow the dosage that your own doctor prescribes. These recommended daily dosages are from the company's own website but are less than what was taken in some of the trials. Go figure!
A 2005 study of 31 people who had been given 2 weeks of ciprofloxacin before hand did not show the same success rate as these other trials.4
A 2013 review of current research found that "Based on this, VSL#3 is approved for the prevention and the maintenance of remission of pouchitis, and the efficacy is stated also in referral European guidelines."6
A supportive forum where experiences are shared and information swapped can be found at J pouch. Lots of helpful information there and you can hear what is working for people and what isn't.
1. Gionchetti P, Rizzllo F, Venturi A et al. Oral bacteriotherapy as maintaining treatment in patents with chronic pouchitis: a double-blind, placebo-controlled trial. Gastroenterology 2000; 119 pp305-309
2. T Mimura, F Rizzello, U Helwig, G Poggioli, S Schreiber, I C Talbot, R J Nicholls, P Gionchetti, M Campieri, M A Kamm. Once daily high dose probiotic therapy (VSL#3) for maintaining remission in recurrent or refractory pouchitis. Gut 2004;53:108-114
3. Gionchetti P, Rizzllo F, Venturi A et al. Prophylaxis of pouchitis onset with probiotic therapy: a double-blind, placebo-controlled trial. Gastroenterology 2003;124:1202-1209
4. Shen B, Brzezinski A, et al. Maintenance therapy with a probiotic in antibiotic-dependent pouchitis: experience in clinical practce. Aliment Pharmacol Ther 2005 Oct 15;22(8):721-8
5. Uronis JM, Arthur JC, Keku T, Fodor A, Carroll IM, Cruz ML, Appleyard CB, Jobin C. Gut microbial diversity is reduced by the probiotic VSL#3 and correlates with decreased TNBS-induced colitis. Inflamm Bowel Dis. 2011 Jan;17(1):289-97. doi: 10.1002/ibd.21366.
6. Franco Scaldaferri, Viviana Gerardi, Loris Riccardo Lopetuso, Fabio Del Zompo, Francesca Mangiola, Ivo Boškoski, Giovanni Bruno, Valentina Petito, Lucrezia Laterza, Giovanni Cammarota, Eleonora Gaetani, Alessandro Sgambato, and Antonio Gasbarrini. Gut Microbial Flora, Prebiotics, and Probiotics in IBD: Their Current Usage and Utility. Biomed Res Int. 2013; 2013: 435268. Published online Aug 7, 2013. doi: 10.1155/2013/435268