VSL#3 / Visbiome (multi-strain)

Tier 2 — promising · IBD · Pouchitis · Gut barrier

A high-potency multi-strain probiotic with strong evidence for inflammatory bowel disease. Multiple trials show it induces and maintains remission in ulcerative colitis pouchitis. Contains 8 strains at 450 to 900 billion CFU per dose, far higher than typical probiotics. The original formula (now sold as Visbiome) has the clinical evidence — generics may not be equivalent. Requires refrigeration.

Dose: 1–2 sachets/day (450–900 billion CFU); requires refrigeration; use Visbiome for original formula