Inclusion Criteria:

• - Adult patients (age 18 or older) diagnosed with MS (Relapsing-remitting type) or CIS and recruited within 10 years of symptom onset, and.

• - Adult patients receiving anti-CD20 therapy (rituximab or ocrelizumab) who have received at least one cycle at the time of recruitment.

Exclusion Criteria:

• - Active relapse within 3 months of enrollment.

• - Steroid use within 4 weeks of enrollment.

• - Antibiotics use within 3 months of enrollment.

• - Daily pre or prebiotic use within 3 months of enrollment.

• - Diagnosed with any of the autoimmune disorders: Rheumatoid Arthritis, Lupus, Celiac disease, Vitiligo, Psoriasis, Psoriatic Arthritis, Hashimoto's Thyroiditis, Graves' Disease, Sjogren's syndrome, Type 1 Diabetes, Scleroderma, Crohn's Disease, Ulcerative Colitis, Alopecia Areata.

• - Had surgery of the GI tract in the last 5 years (with the exception of cholecystectomy and appendectomy) - Had a major bowel resection.

• - Prior use of any of the following drugs: Mycophenolate/Cellcept, Cyclophosphamide/Cytoxan, Methotrexate/Novantrone, Azathioprine/Imuran, Cladribine/Leustatin/Mavenclad, Daclizumab/Zenepax, Alemtuzumab/Campath/Lemtrada.

• - Have any of the following active uncontrolled gastrointestinal (GI) illnesses: 1.

Crohn's disease, ulcerative colitis, indeterminate colitis. 2. Irritable bowel syndrome: moderate-severe. 3. Persistent or chronic diarrhea of unknown etiology. 4. Severe Chronic constipation or difficulties with defecation. 5. Persistent, infectious gastroenteritis, colitis or gastritis. 6. Clostridium difficile infection (recurrent) 7. Gastric or intestinal ulcerations/GI bleeding. 8. Gastrointestinal or colonic malignancy: polyps, masses, dysplasia or cancer.

• - Active use of bismuth subsalicylate-containing products.

- Currently pregnant

Soluble fibers (prebiotics) are fermented by beneficial bacteria (probiotics) in the colon to produce short-chain fatty acids (SCFAs) which are the main source of nutrition for the cells in the gut. It has been reported that the fermentable fiber inulin and SCFAs may exert some beneficial effects including anti-inflammatory effect on the immune system. To date, the effect of supplementation with fermentable dietary fiber, such as prebiotics in patients with Multiple Sclerosis (MS) has not been investigated.

Arms

Other: Prebiotic/ Probiotic

These subjects will be assigned to first receive prebiotics (Prebiotin Prebiotic Fiber Stick Pac) for 6 weeks. Then after a 6 week wash-out period, subjects will take probiotics (Visbiome®) for 6 weeks (followed again by a 6 week washout period).

Other: Probiotic/ Prebiotic

These subjects will be assigned to first receive probiotics (Visbiome®) for 6 weeks. Then after a 6 week wash-out period, subjects will take (Prebiotin Prebiotic Fiber Stick) for 6 weeks (followed again by a 6 week washout period).

Interventions

Dietary Supplement: - Prebiotics (Prebiotin Prebiotic Fiber Stick Pac)

Commercially available Prebiotin Prebiotic. 2 packets (Inulin 4000 mg), Twice Daily (Total of 16 g Daily)

Dietary Supplement: - Probiotics (Visbiome®)

Commercially available Probiotics Visbiome extra strength, which is a combination of live lactic acid bacteria probiotics that have been cultivated, freeze-dried and mixed in very high concentrations. 2 packets (450 billion CFU), Twice Daily (Total of 3,600 billion Daily)