By Dr Pranab Gyawali, Consultant Gastroenterologist
Many of my patients in Dubai with ulcerative colitis, Crohn’s disease, IBS and chronic gut symptoms have already tried one or more probiotic products. Pharmacies in the UAE are full of options, and the advice online can be overwhelming.
A major review published in the journal Gut (2025) gives one of the clearest explanations yet of how probiotics actually work, what they don’t do, and how new “next-generation probiotics” may change IBD treatment in the future.
In this VLOG article, I answer the most common questions I hear from my ulcerative colitis and Crohn’s patients in Dubai.
Do probiotics help ulcerative colitis or Crohn’s disease?
Short answer: sometimes in UC, rarely in Crohn’s.
In ulcerative colitis, certain probiotics — especially E. coli Nissle — have shown benefit in maintaining remission for some patients. In Crohn’s disease, standard probiotics generally have not been shown to induce or maintain remission. Many over-the-counter probiotics simply pass through the gut without meaningfully changing inflammation.
The Gut review confirms this: probiotics have a limited, disease-specific role and should not be seen as a standalone treatment.
Why do standard probiotics often fail in IBD, especially Crohn’s?
Most commercial probiotics were never designed for IBD. They:
- Contain strains that play a relatively small role in the human gut ecosystem
- Do not usually engraft — they don’t stay long enough in the microbiome
- Have modest immune effects compared with the degree of inflammation seen in Crohn’s disease
This explains why many Crohn’s patients see little or no benefit from typical probiotic capsules.
What are “next-generation probiotics” or live biotherapeutic products?
This is where the science becomes exciting. Next-generation probiotics (also called live biotherapeutic products) are very different from standard probiotics. They are:
- Based on key gut bacteria such as Akkermansia muciniphila or Faecalibacterium prausnitzii
- Designed to interact with the gut lining, reduce inflammation or strengthen the mucus barrier
- Developed as carefully designed consortia or engineered formulations
- Still in clinical trials and not yet available for routine use in Dubai
These future treatments are very different from current probiotic supplements and may become part of personalised IBD care.
Should I take probiotics during a flare?
This depends on your condition and should always be discussed with your treating specialist.
- In ulcerative colitis: certain probiotics may help with maintaining remission or supporting mild disease, but they cannot replace standard treatments during a flare.
- In Crohn’s disease: the evidence for probiotics during flares is weak, so the focus is usually on controlling inflammation properly with medical therapy.
During a flare, the priority is to bring inflammation under control safely. Probiotics, if used at all, are supportive — not primary treatment.
What probiotic do you recommend for Crohn’s and ulcerative colitis in Dubai?
My approach for IBD patients in Dubai is always assessment first — and diet before probiotics.
1. Start with diet
I start with a Mediterranean-style, whole-food, largely plant-based diet. This pattern has consistently shown benefits for gut microbiome diversity, inflammation reduction and long-term bowel health. Many patients in Dubai notice a clear improvement when we optimise diet.
2. Understand disease activity
Before recommending any probiotic, we look at:
- Current symptoms
- Stool markers such as calprotectin
- Blood tests
- Medication history and current treatment
- Whether the patient is in remission, mild activity or a flare
The benefit of probiotics depends heavily on where the disease is at that moment.
3. Selective use of probiotics
For ulcerative colitis, there may be a role for certain strains such as E. coli Nissle in maintaining remission. For Crohn’s disease, I rarely recommend standard probiotics because the evidence remains limited.
4. Microbiome testing
For patients who want personalised care, I sometimes use gut microbiome testing. This can help identify which beneficial species are reduced or missing, whether inflammatory bacteria are over-represented, and how we might individualise diet to support gut repair. This is particularly useful for patients who are keen on a more tailored, science-based nutritional strategy.
IBD-Focused VLOGs & Patient Education
- Engineered Probiotic for Ulcerative Colitis 2026
- Is Your Gut Microbiome Behind Crohn’s Disease Flares?
- Diet, Microbiome & IBD
- How Biologics Work in Crohn’s & Colitis
- Predicting Biologic Treatment Success in Crohn’s & UC
- IBD Treatment Updates & What’s Changing
- Rinvoq for Crohn’s & Ulcerative Colitis
- Tremfya (Guselkumab) Explained
- SIBO in Crohn’s & UC
- Stress and the Gut–Brain Axis in IBD
Recommended IBD Resources
Nutrition & IBD
- What Can I Eat If I Have IBD?
- Coffee and Bread in Crohn’s & Ulcerative Colitis
- Ultra-Processed Foods and Gut Inflammation
- Vitamin D and Gut Health in IBD
- Iron-Rich Foods for Anaemia in Crohn’s & Colitis
- B12 and Folate Deficiency in IBD