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Head-to-head evidence comparison — which supplement is right for you?
L. reuteri DSM 17938 vs VSL#3 / Visbiome: they're closely matched on evidence (6 vs 6.5/10); they're alternatives for improve digestion — the best pick depends on your goals. Take the 60-second quiz for a pick tailored to your goals.
L. reuteri DSM 17938 and VSL#3 / Visbiome are closely matched across evidence, studies, and safety.
Verdict
Mostly mechanism / observational
Top outcomes
Verdict
Too few graded studies
Top outcomes
1 x 10^8 CFU daily (5 drops) for infant colic — the dose used in every positive trial
Any time of day
Oil-suspension drops standardized to DSM 17938
Prevention and maintenance are DIFFERENT doses and are often conflated. Preventing the first onset of acute pouchitis used 900 billion CFU/day (1 sachet). Maintaining remission in established chronic or refractory pouchitis — where the effect size is largest — used 6 g/day, which at 5 x 10^11 viable bacteria per gram is about 3 trillion CFU/day, in both maintenance trials. As a ulcerative colitis add-on, 3.6 trillion CFU daily; the active-UC induction trial went highest at 3.6 trillion CFU TWICE daily (7.2 trillion/day), and the paediatric trial lowest at 450 billion/day weight-based
Any time of day
Refrigerated sachet of the De Simone Formulation
1-3 weeks
n/a
1-3 days
4 weeks
9-12 months
12 months
8-12 weeks
n/a
Lactobacillus reuteri to Treat Infant Colic: A Meta-analysis.
Pediatrics (2018) · Meta analysis
Day-21 adjusted mean difference in cry/fuss time: -25.4 min/day (95% CI -47.3 to -3.5)
Treating infant colic with the probiotic Lactobacillus reuteri: double blind, placebo controlled randomised trial.
BMJ (2014) · Rct · n=167
Probiotic group cried/fussed 49 minutes MORE than placebo at 1 month (95% CI 8 to 90, P=0.02)
Probiotics to prevent infantile colic.
Cochrane Database Syst Rev (2019) · Meta analysis
No difference in new cases of colic: RR 0.46 (95% CI 0.18-1.19), low certainty
Treatment and prevention of pouchitis after ileal pouch-anal anastomosis for chronic ulcerative colitis.
Cochrane Database Syst Rev (2019) · Meta analysis
Chronic pouchitis maintenance: 85% (34/40) maintained remission at 9-12 months vs 3% (1/36) placebo — RR 20.24 (95% CI 4.28-95.81), low certainty
Oral bacteriotherapy as maintenance treatment in patients with chronic pouchitis: a double-blind, placebo-controlled trial.
Gastroenterology (2000) · Rct · n=40
Relapse in 3/20 (15%) on the probiotic vs 20/20 (100%) on placebo, P<0.001
Once daily high dose probiotic therapy (VSL#3) for maintaining remission in recurrent or refractory pouchitis.
Gut (2004) · Rct · n=36
Remission maintained at 1 year in 17/20 (85%) vs 1/16 (6%) placebo, p<0.0001
Both L. reuteri DSM 17938 and VSL#3 / Visbiome are closely matched — the best choice depends on your specific health goals.
For improve digestion, L. reuteri DSM 17938 has a higher relevance score (55 vs 52).
No documented interaction was found in the data searched. This does not establish that this exact combination is safe.
The right pick depends on your goals. Answer a few quick questions for a personalised recommendation — or dig into the full evidence on each.