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Head-to-head evidence comparison — which supplement is right for you?
L. rhamnosus GG 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. rhamnosus GG and VSL#3 / Visbiome are closely matched across evidence, studies, and safety.
Verdict
Mostly mechanism / observational
Top outcomes
Verdict
Mostly mechanism / observational
Top outcomes
10-20 billion CFU (1-2 x 10^10) daily; 10 billion CFU/day is the effective floor
any
Capsule standardized to ATCC 53103
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
Refrigerated sachet of the De Simone Formulation
During the antibiotic course
During hospital stay
n/a
n/a
9-12 months
12 months
8-12 weeks
n/a
Lactobacillus rhamnosus GG versus Placebo for Acute Gastroenteritis in Children.
N Engl J Med (2018) · Rct · n=971
Primary outcome (modified Vesikari score >=9 within 14 days): 11.8% with LGG vs 12.6% placebo; RR 0.96 (0.68-1.35), P=0.83
Systematic review with meta-analysis: Lactobacillus rhamnosus GG in the prevention of antibiotic-associated diarrhoea in children and adults.
Aliment Pharmacol Ther (2015) · Meta analysis
Antibiotic-associated diarrhea fell from 22.4% to 12.3%; RR 0.49 (0.29-0.83) pooled across 11 RCTs, n=1,308 (12 RCTs, n=1,499 included overall)
Probiotics for treating acute infectious diarrhoea.
Cochrane Database Syst Rev (2020) · Meta analysis
In studies at low risk of bias, no difference in diarrhea lasting >=48 hours (RR 1.00, 0.91-1.09; moderate 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. rhamnosus GG and VSL#3 / Visbiome are closely matched — the best choice depends on your specific health goals.
For improve digestion, L. rhamnosus GG has a higher relevance score (72 vs 52).
No known interactions between L. rhamnosus GG and VSL#3 / Visbiome have been documented in our database. However, always consult a healthcare provider before combining supplements.
The right pick depends on your goals. Answer a few quick questions for a personalised recommendation — or dig into the full evidence on each.