Visbiome Effect on Colorectal Anastomosis and Local Recurrence

Inclusion Criteria:

* At least 18 years of age
* Diagnosis of biopsy proven rectal cancer (CT/MRI)
* Willing and able to comply with protocol requirements
* Able to tolerate surgery
* Able to comprehend and have signed the Informed Consent
* Absence of metastatic disease
* Clinical performance status of ECOG 0 or 1
* Life expectancy of greater than 3 months
* Planned ileostomy as part of their routine care

Exclusion Criteria:

* Severe or refractory ulcerative colitis defined as Mayo Score of greater than or equal to 10, endoscopic disease activity score 3
* Untreated enteric infection (positive stool test for any of the following: clostridium difficile, salmonella, shigella, yersinia, campylobacter, enteropathogenic E. coli or other enteric infection at the discretion of the Investigator
* Severe immunodeficiency, inherited or required (e.g. HIV, chemotherapy or radiation therapy)
* Patients with the following laboratory abnormalities: absolute neutrophil count \<1000/ul, platelets \<50 x 10\^9/L, hemoglobin \<6.5g/dL
* History of anaphylaxis (severe allergic reaction) to food allergens (e.g. tree nuts, shellfish)
* Active intestinal obstruction
* Non-steroidal anti inflammatory medications (NSAIDs) as long-term treatment, defined as for at least 4 days per week each month
* Cholestyramine use
* Any condition in which the Investigator thinks VSL3 administration may pose a health risk (e.g. severely immunocompromised)
* Simultaneous participation in another interventional clinical trial
* Patients who are pregnant, breast feeding or planning pregnancy during study trial period
* Patients with any other signification medical condition that could confound or interfere with evaluation of safety, tolerability or prevention compliance with the study protocol at the discretion of the Investigator