For some background, I was diagnosed with moderate UC about six years ago, Asacol treated me the first time, then I only had mild symptoms for five years before i had another moderate flare (5/10) and had to go on prednisone/Asacol for treatment. After coming off prednisone, I felt my symptoms coming back and after a lot of reading (I'm a PhD chemical engineer in biotech) combined Asacol with 2 statchels of VSL3/day. I now am normal - I wanted to pass on my story in case it can help some people. I understand that my symptoms were moderate compared to what some of you are dealing with, but I thought I would share.

Why probiotics, and I apologize in advance if this is redundant for folks? UC is a Treg disease, in short your immune system has to constantly sort between antigens that are self and antigens that are benign and antigens that are harmful. You have a tremendous amount of flora in your large intestine (60% of the dry weight in your crap) so you can imagine that this gets quite complex for the immune system as it has to sort between benign/helpful bacteria and things like C-diff ect. The cells that control this regulation are called Tregs and there job in life is to down regulate the immune systems when appropriate.

Likely due to western diet, and the fact that we are too clean in the western world and don't have parasites ect (another story altogether) , its quite easy for our Tregs to get downregulated in western society. Consequently, I read up quite a bit on how to upregulate Tregs. After numerous reviews, the things I identified are Vitamin D, fish oils, probiotics, and vitamin A. The key to this is that you can't screw around - For fish oils, you need 4-5 grams/day. That's alot of pills. For probiotics, I take two satchels of VSL3/day. I'm highly confident that the run of the mill "probiotics" do not have enough kick to make a difference in your LI flora as you have so much mass there to begin with (again 60% of your crap is flora). Why VSL3 versus others - I haven't done a detailed study on other probiotics but VSL3 contains the bacteria that were cited in this PNAS paper to eliminate UC in murine studies. (See Proceeding of the National Academy of Sciences, Kwon, 2009, pg 2160 - its freely accessed)

So in short - it really made a big difference for me and has a lot of technical merit. I would never say don't take your meds - they should always be used. But I would definately take an integrative approach and try to support the western meds with probiotics. My doctors really diminished the use of probiotics, but the more mechanistic side suggests that there is something to it. The lack of clinical studies is more due to the cost of such studies for non-patentable products more than anything else. Lastly, it can't hurt and its worth a shot - but again don't screw around, make sure you buy probiotics that have been shown to help in the PNAS paper. They all aren't the same.

Hope this helps - I would be happy to talk science with those that are interested - mbseefeldt@yahoo.com.

Matt