Ulcerative colitis is a chronic inflammatory bowel disease affecting the lining of the colon and rectum causing inflammation and ulcers. Symptoms include bloody diarrhea, severe abdominal cramping, urgency, fatigue, and weight loss. Like Crohn's disease it is now understood as a gut microbiome disease: patients show consistent dysbiosis patterns including reduced Faecalibacterium prausnitzii and Bifidobacterium levels. Emerging clinical trials are investigating targeted probiotic therapy as an adjunct to standard treatment.