Probiotics for Ulcerative Colitis: Should You Try Them?
Ulcerative ColitisHow to Manage and Treat UC

Should You Try Probiotics for Ulcerative Colitis?

Should You Try Probiotics for Ulcerative Colitis?
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By
and Tabitha Britt
Updated on October 9, 2025
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You can find probiotics everywhere, from foods in the grocery store to the supplement section of your local pharmacy. Probiotics are live “friendly” bacteria that are often marketed as a way to improve gut health and aid digestion.

If you have ulcerative colitis (UC), you should be cautious about what kinds of probiotics you try. While foods naturally rich in probiotics (like yogurt, kefir, and sauerkraut) can be a part of a healthy diet for many with UC, the most recent clinical guidelines from the American College of Gastroenterology recommends against the use of probiotic supplements for reaching remission in UC, citing a lack of strong scientific evidence of their benefit.

“Patients with UC have an imbalance in their gut bacteria,” says David Hudesman, MD, the director of the inflammatory bowel disease center at New York University Langone Health in New York City. “We don’t have a great understanding of how to apply that clinically,” he says. In other words, more studies on probiotics and UC need to be done to assess which types of probiotics may help and how.

What the Research Says About Probiotic Supplements for UC

While probiotic supplements are popular for general digestive health, current medical guidelines do not recommend probiotic supplements for treating active UC. The American College of Gastroenterology conducted a thorough review of the available research and found insufficient evidence to support the use of supplements for this purpose.

“Feeling well and being healed inside don’t always go together,” Dr. Hudesman says. “The use of probiotics may improve symptoms but will not heal the underlying inflammation.”

The only exception noted by the AGA is for preventing pouchitis, a condition that can occur after corrective surgery for UC. For this specific complication, certain probiotics are recommended.

 “There is evidence that probiotics may help prevent recurrent pouchitis in people who have already had it,” Hudesman says.

What Are the Potential Risks of Taking Probiotics?

Probiotics are generally safe for most people; however, they can pose several risks for people with UC, especially during a flare.

“We know the intestinal flora is very important to the development of IBD,” says Jessica Philpott, MD, PhD, a gastroenterologist who specializes in inflammatory bowel disease (IBD) at the Cleveland Clinic in Ohio. “But more research is needed to have a better understanding of how to adjust the intestinal flora — either with probiotic supplements, medications, or foods — to treat or even prevent IBD.”

It’s important to discuss any potential downsides with your doctor, such as:

  • Worsening GI symptoms. Some studies have found that people with inflammatory bowel disease who are taking probiotics may experience a higher risk of side effects, such as abdominal pain, compared with those taking a placebo.

  • Risk of serious infections. Although rare, probiotics have been linked to dangerous bloodstream infections bacteremia and fungemia) in people who are already severely ill or have a compromised immune system.

  • Lack of regulation. Probiotics are typically sold as dietary supplements, so they aren’t regulated with the same rigor as prescription drugs. The type of bacteria, dose, and purity can vary widely between products, and there is no guarantee of quality or safety.

  • Not all strains are equal. It’s also difficult to know which type of probiotic might be effective. “There are numerous probiotic therapies with many different types of bacteria, numbers, and delivery agents,” Dr. Philpott says. “One probiotic may provide health benefits in a certain environment, while another probiotic strain may not.”
  • Delaying effective care. Choosing a probiotic instead of a proven medical therapy could delay effective treatment from your doctor and make matters worse. “If you’re very sick with severe colitis and use probiotics rather than known, effective therapies, you might incur some harm in delaying to treat the colitis,” Philpott says.

Other Ways to Support Your Gut Health With Ulcerative Colitis

If you’re thinking about trying a probiotic supplement, be sure to talk to your doctor before taking it, to ensure it’s safe for you. It’s also important to remember that probiotic supplements are not a substitute for medical treatment for UC. “If you are taking probiotics, it should be in combination with your prescribed medical therapy, not as a replacement for,” Hudesman says.

While probiotic supplements may not be the answer for managing your UC symptoms, there are other effective, evidence-based strategies you can use to support your gut health and overall well-being.

1. Focus on a Tolerable Diet

There’s no single diet that works for everyone with UC, but your food choices can play a significant role in managing symptoms. During a flare, many people find that soft, bland foods are easier to tolerate. It can also be helpful to keep a food journal to identify your personal trigger foods, so that you know what to limit or avoid in the future. For personalized and safe dietary advice, the best approach is to work with a registered dietitian who specializes in IBD, says Hudesman.

2. Do Your Best to Manage Stress

The connection between the brain and the gut is powerful, and while stress doesn’t cause UC, it can trigger or worsen symptom flares in some people. Finding healthy ways to manage stress is an important part of a holistic treatment plan. Some examples include:

  • Gentle exercise, like walking or yoga
  • Mindfulness meditation
  • Deep breathing exercises

3. Prioritize Sleep

Getting enough sleep is also important for managing a chronic inflammatory condition. Poor sleep can disrupt the immune system and may make UC symptoms worse over time. Aiming for seven to eight hours of consistent sleep per night can help support your body and improve your overall well-being.

The Takeaway

  • Current medical guidelines do not recommend probiotic supplements for treating active UC, due to a lack of strong scientific evidence. The only exception is for preventing pouchitis, a complication that can occur after surgery.
  • Taking probiotic supplements carries potential risks, including worsening digestive symptoms and, in rare cases, serious infections for those who are severely ill or immunocompromised.
  • Instead of focusing on probiotics, talk with your doctor about other evidence-based ways to support your gut health, such as standard UC treatments, diet, and stress management. Always consult a healthcare professional before trying any supplement, and never use one as a replacement for your prescribed medication.

Resources We Trust

EDITORIAL SOURCES
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Resources
  1. ACG Clinical Guideline Update: Ulcerative Colitis in Adults. American College of Gastroenterology. June 2025.
  2. Probiotics and Microorganisms. Crohn’s & Colitis Foundation.
  3. Huang C et al. Probiotics for the Treatment of Ulcerative Colitis: A Review of Experimental Research From 2018 to 2022. Frontiers in Microbiology. July 6, 2023.
  4. Ma Y et al. Probiotics for Inflammatory Bowel Disease: Is There Sufficient Evidence? Open Life Sciences. April 5, 2024.
  5. Liu X et al. Accounting for the Health Risk of Probiotics. Heliyon. March 30, 2024.
  6. Merenstein D et al. Emerging Issues in Probiotic Safety: 2023 Perspectives. Gut Microbes. March 15, 2023.
  7. A Nutritional Plan for Anyone Living With Crohn’s Disease or Ulcerative Colitis. Cleveland Clinic. January 30, 2024.
  8. Stress and IBD: Breaking the Vicious Cycle. Crohn’s & Colitis Foundation. August 7, 2024.
  9. Poor Sleep Patterns Could Increase Your Chance of Developing Ulcerative Colitis. GI Society: Canadian Society of Intestinal Research. July 28, 2020.
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Waseem-Ahmed-bio

Waseem Ahmed, MD

Medical Reviewer

Waseem Ahmed, MD, is an assistant professor of medicine in the Karsh Division of Gastroenterology and Hepatology at Cedars-Sinai Medical Center in Los Angeles and serves as Director, Advanced Inflammatory Bowel Disease Fellowship and Education within the F. Widjaja Inflammatory Bowel Disease Institute.

He received his undergraduate degree from the University of Michigan and attended medical school at Indiana University. He then completed an internal medicine residency at New York University, followed by a fellowship in gastroenterology and hepatology at Indiana University, and an advanced fellowship in inflammatory bowel disease at the Jill Roberts Center for Inflammatory Bowel Disease at New York-Presbyterian Hospital/Weill Cornell Medicine. Prior to his current role, Dr. Ahmed served as an assistant professor of medicine within the Crohn’s and Colitis Center at the University of Colorado from 2021-2024.

Dr. Ahmed is passionate about providing innovative, comprehensive, and compassionate care for all patients with inflammatory bowel disease (IBD). His research interests include IBD medical education for patients, providers, and trainees; clinical trials; acute severe ulcerative colitis; and the use of combined advanced targeted therapy in high-risk IBD.

He enjoys spending time with his wife and dog, is an avid follower of professional tennis, and enjoys fine dining.

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Sandra Gordon

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Sandra Gordon is a health and medical writer with decades of experience writing for consumers and physicians online and in print. She has written for Prevention, Parents, Self, Energy Times, WebMD, the Cleveland Clinic, NYU Langone Health, Your Teen, Spirit of Women, Arthritis Today, dLife, HealthProview, and Medical Economics, among others. She's also the author of 11 books including the upcoming Gifted: My Journey of Surviving a Double Liver Transplant. Gordon is ghostwriting the autobiography.

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Tabitha Britt

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