酸化マグネシウムは日本国内において古くから制酸・緩下剤として使用されており，慢性便秘症治療薬の第一選択薬として位置づけられている．しかし，注意すべき副作用として発現率は低いものの高マグネシウム血症が挙げられる．高マグネシウム血症は高齢者や腎機能低下症例で多く認められる傾向にあるが，腎機能低下を認めない症例も報告されており，その症例の中には腸閉塞や便塞栓等の十分に排便がコントロールされていない症例が散見される．
そこで本研究では，国内において経口マグネシウム製剤の内服により高マグネシウム血症を来した症例の中で，腸閉塞や便塞栓など十分に排便がコントロールされていないことが原因と推察される症例報告を調査した．その結果，経口マグネシウム製剤による高マグネシウム血症の報告件数は2001～2021年で163症例が該当し，そのうち高度腎機能低下を伴う症例を除いた腸閉塞や便塞栓等を有する症例は59症例であった．これらの症例の多くは，十分な排便がなされていない状態で継続的に経口マグネシウム製剤を服用したことで，腸管内に大量の糞便とともにマグネシウムが停滞し，高マグネシウム血症を来したと推察される．経口マグネシウム製剤の服用者に対しては排便状況をしっかり確認し，事前に十分な排便を促すことにより腸管からのマグネシウムの過度な吸収を防ぐことで高マグネシウム血症の予防につながると推察された．
酸化マグネシウム服用患者における高マグネシウム血症のリスク因子としてこれまでは腎機能低下が特に注目されてきたが，便塞栓など腸管が閉塞している患者への投与も高マグネシウム血症のリスクと推察され，避けるべきと考える．まず閉塞状態を脱する処置をしたのちに酸化マグネシウム製剤を投与することで，より安全に使用できるものと考えられる．
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