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Probiotic yogurt products have become very popular for treating constipation. Manufactured to provide live strains of Bifidobacterium lactis, which the makers of Activia have renamed Bifidobacterium regularis.

What to Do When Activia Does Not Work?

Activia and similar products promise regularity to encouraging the growth of bacteria that add bulk to the stool.

Up to about 1/3 of the content of the bowel is bacteria. These living organisms absorb water and make it easier for the bowels to move. Or at least that's the theory.

Previous research has shown that products like Activia are effective for relieving constipation in adult women. Scientists in the Netherlands and Poland wanted to learn whether these products also relieve constipation in children.

The researchers recruited parents of 160 children with constipation to participate in a study. All of the children had two or fewer bowel movements per week. Half of the children were given a yogurt product with live strains of Bifidobacterium lactis to eat every day for three weeks. Half of the children were given a yogurt product that did not contain the live bacteria. The parents of 12 of the children did not return for follow-up visits, so the researchers later examined 74 of the children in each group to see whether the probiotic product actually worked.

Despite what you may see in some of the headlines, the probiotic product did result in more productive trips to the bathroom. Before the intervention, none of the children in either group had more than 2 bowel movements per week. After the intervention, the children who got an Activia-like product had an average of 2.9 bowel movements per week.

But the regular yogurt worked almost as well. Children in this group started having an average of 2.6 bowel movements per week. Neither group could be said to be truly "regular," and the difference between the two groups was not statistically significant. But there was something about yogurt, just not necessarily probiotic yogurt, that relieved children's constipation. Neither product caused significant side effects other than flatulence.

Both Activia and regular yogurt should relieve children's constipation, without causing diarrhea.

What can parents do if Activia does not work?

Children who do not defecate for three consecutive days need laxatives, but these laxatives must be gentle.

Look for a laxative containing the ingredient bisacodyl. In the United States, Canada, Australia, New Zealand, Russia, Latin America, Eastern Europe, and the European Union, you can buy bisacodyl in the form of Dulcolax, without a prescription. This laxative ingredient helps children who are unable to go to the bathroom for a productive bowel movement for more than 3 days in a row. Unlike other laxatives, it does not disturb the bacteria in the lining of the colon. This allows Activia, or any other probiotic product, to continue to do its work. It may take four to six weeks for probiotic bacteria to establish themselves.

It is also helpful to make sure your child eats some fruits and vegetables every day. Probiotic bacteria need their own food source, and that food source is the fiber in the foods humans eat. What is "indigestible" to us is nutritious to them. Because undigested fiber itself can be constipating, don't add fiber-rich foods to your child's menu before you add probiotics.

  • Tabbers MM, Chmielewska A, Roseboom MG, Crastes N, Perrin C, Reitsma JB, Norbruis O, Szajewska H, Benninga MA. Fermented Milk Containing Bifidobacterium lactis DN-173 010 in Childhood Constipation: A Randomized, Double-Blind, Controlled Trial. Pediatrics. 2011 May 23. [Epub ahead of print]
  • Photo courtesy of srgblog on Flickr: