Probiotics and their efficacy for individuals with SIBO is a controversial topic for which I have been on both sides. At times, probiotics have worsened my SIBO symptoms and at other times they have been very beneficial. But no probiotic formula has been as effective for me as VSL#3. In this post I will discuss research that has been conducted on VSL#3 in regard to improving symptoms of constipation. VSL#3 has also been studied for a variety of other conditions- I encourage you to search on PubMed for more information.
Having regular bowel movements is extremely important for detoxification because it is a process by which waste is removed from the body. Alarmingly, it is estimated that as much as 27.1 percent of the US population suffers from functional constipation . Fortunately, low-risk remedies such as probiotics exist to aid in this important detoxification process. Studies have indicated that administration of VSL#3 can positively impact symptoms of constipation. It is unclear whether the benefits of VSL #3 probiotic supplementation are temporary or whether they can provide lasting improvement.
VSL#3 contains eight probiotic strains including Streptococcus thermophilus, Bifidobacterium breve, Bifidobacterium longum, Bifidobacterium infantis, Lactobacilus acidophilus, Lactobacillus plantarum, Lactobacillus paracasei, and Lactobacilus delbrueckii subsp. bulgaricus.
A 2015 study  regarding the efficacy of the probiotic formulation VSL#3 showed positive benefits in individuals with functional constipation selected based on Rome III criteria. Before administration of the probiotic, lower amounts of bifidobacterium and bacteriodes species were found in the stool of these individuals than in controls. Seventy percent of individuals with functional constipation noted symptom improvement from administration of the probiotic. Additionally, participants noted increased frequency of bowel movements from an average of 2.5 +/- 1.3 per week to 6.3 +/- 3.1 per week. Stool consistency (based on the Bristol Stool Chart) improved from an average of 2.6 +/- 0.7 before treatment to 4.1 +/- 0.9 after the two week probiotic therapy. Unfortunately, the results were not lasting. Of the participants who experienced symptom improvement during probiotic administration, 61 percent reported return of hard stools or less frequent bowel movements within one month of the study’s completion.
It appears that VSL#3 may be only a remedy, not a cure. At a cost of approximately $9-10 per day, administering VSL #3 at the dose utilized in this study may be prohibitive for many individuals. However, VSL#3 may be an effective and welcomed means of symptom relief for individuals with chronic constipation. No adverse reactions were noted in the study I analyzed, indicating that these protocols may be safe treatments for promoting elimination and therefore, detoxification. Of course, it is always recommended that you consult your physician to ensure safety.
 Schmier JK, Miller PE, Levine JA, et al. Cost savings of reduced constipation rates attributed to increased dietary fiber intakes: a decision-analytic model. BMC Public Health. 2014;14:374.
 Kim SE, Choi SC, Park KS, et al. Change of Fecal Flora and Effectiveness of the Short-term VSL#3 Probiotic Treatment in Patients With Functional Constipation. J Neurogastroenterol Motil. 2015;21(1):111-20.
Thank you for your information on this probiotic. I will buy and and test it out. Did you take this supplement after your abx protocol? or During? I’m currently on Xifaxan + Neomycin, day 10, and I find myself to be more constipated than ever before.
I did not take any probiotics during my antibiotic or antimicrobial protocol. The current consensus among SIBO experts seems to be no probiotics during treatment.
Would you recomend this even if you’re SIBO is not cleared?
That’s a tricky one because I think that “cleared” with SIBO is a really difficult thing to quantify and can mean different things to different people. I think one thing we know for certain is that the large intestine is where we want the bacteria to be, not the small intestine, so motility needs to be addressed. Studies also show that dysbiosis in the large intestine is correlated with IBS. But what is unclear is whether the motility issue is causing that or whether the dysbiosis leads to motility issues (a chicken & an egg scenario if you ask me!)
I can tell you a personal example from yesterday that may help. I ate 1/2 of an apple at lunch time and noticed that my small intestine was pretty tender to the touch afterward. In the past, I would have taken antimicrobials to make it go away. But instead, I took two VSL#3 capsules and within an hour, the tenderness had subsided. I am very interested in learning more about the mechanism behind how this works. I am planning to take a Gut Immunology class next term which will hopefully shed some light on all of this!
I know this is not very helpful since you probably wouldn’t be reading my blog if your doctor had all the answers, but you may want to ask your doctor and see what they think about whether it is a good time to introduce a probiotic such as this one. VSL#3 is intended to be used under the care of a physician anyways, although I do not have any issue picking it up from a natural pharmacy called Pharmaca without a prescription.
Kat Immuneliving says
Vsl3 has been extremely helpful to me. I recently switched to prescription assist and I experienced “fast motility ” my stool was green and not formed. Sorry to be so descriptive. But It appears my body was not yet ready for that probiotic / prebiotic. I’m back to vsl3 and have not had any motility issues.