The osmotic and intrinsic mechanisms of the pharmacological laxative action of oral high doses of magnesium sulphate. Importance of the release of digestive polypeptides and nitric oxide.

A common use for high doses of oral magnesium salts is to produce a laxative effect to treat constipation. In the intestinal lumen the poorly absorbable magnesium ions (and other ions such as sulphate) exert an osmotic effect and cause water to be retained in the intestinal lumen. This increases the fluidity of the intraluminal contents and results in a laxative action. Although the laxative action of magnesium is thought to be due to a local effect in the intestinal tract, it is also possible that released hormones such as cholecystokinin or activation of constitutive nitric oxide synthase might contribute to this pharmacological effect. Under normal circumstances the pharmacological administration of high doses of oral magnesium salts is safe and some salts--such as magnesium hydroxide--also have an antacid effect to neutralize stomach acid. However, high doses of magnesium or prolonged use may allow sufficient absorption into the systemic circulation to cause renal or other organ toxicity.