Probiotics only, VSL#3, two criticisms

Recent probiotic research is quite hopeful. Many researchers are testing different strains of probiotics in and out of the lab. However, it's not yet clear which are the most effective.

For example, VSL#3, a high dosage probiotic has had amazing results in treating pouchitis and positive but mixed results in treating ulcerative colitis. In a study published in 2005, 34 patients with active ulcerative colitis were treated for six weeks with a daily dosage of 3.6 trillion bacteria. (Most over the counter probiotics are in the 1 billion range.) For slightly over half the patients, the results were excellent:

# of patients result
18 (53%) remission
8 (24%) some positive response
3 (9%) no response
3 (9%) worse off
2 (5%) did not complete the final assessment
source: VSL#3 Probiotic-Mixture Induces Remission in Patients with Active Ulcerative Colitis, The American Journal of Gastroenterology, Volume 100 Issue 7, Pages 1539-1546 - July 2005

Compared to conventional medicine, the treatment had significantly less side effects. VSL#3's single side effect was mild bloating--experienced by 10 (29%) of the patients. The bloating was not serious enough to stop the treatment.
Two Criticisms (1) When asked about using probiotics without dietary modification, Elaine Gottschall commented:

"If you are not on SCD and are sending loads and loads of fermentable carbs down to the colon as most people are . . . the probiotic bacteria/ae will make things worse . . ."

source: www.scdiet.org

High dosage probiotics such as VSL#3 were not studied at the time of the quote above--VSL#3 replaces a signifcant number of the intestinal flora.

However, Elaine's criticism appears to hold true given that roughly 1/3 of the test subjects experienced bloating and the wide variety of results ranging from remission to worsening of the disease. It would be interesting to know the diets of the study participants.

(2) VSL#s contains strains of bifidus. Elaine had also observed that the probiotic strains of bifidus were not always beneficial. In an injured intestine, extra bifidus in the form of probiotics had a tendency to cause bifidus overgrowth, and further imbalance.


For best results, probiotic usage should be accompanied by dietary changes in order to deprive the harmful bacteria of an energy source. Overall, research from the probiotic side is looking quite positive--several years ago it wasn't even a consideration.

(Before running out to try VSL#3, please find out more. Several anecdotal reports of negative experiences have been reported. If you would like to share any experiences with this, or any other probiotic, please feel free to e-mail this site at scdrecipe (at) gmail (dot) com.)