Pilot study of a topical magnesium preparation to treat hypomagnesaemia in patients with an ileostomy

Abstract

Introduction: Patients with a high output ileostomy often have hypomagnesaemia. This study aimed to determine if a magnesium chloride hexahydrate spray would maintain or increase serum magnesium in ileostomy patients with hypomagnesaemia. Methods: Outpatients with an ileostomy and having chronic hypomagnesaemia (serum magnesium 0.10 mmol/L at week 6, or the avoidance of a planned magnesium infusion. Serum vitamin D and aldosterone levels, and a 24-hour urinary magnesium concentration were measured. Results: 6 patients completed the study, all had normal vitamin D levels (>45 nmol/L), and 5 of 6 had urinary magnesium concentrations below 0.28 mmol/L. 2 patients had a rise in serum Mg+2 of 0.27 and 0.13 mmol/l respectively and one avoided their planned six-weekly magnesium infusion, No patient had a fall in serum Mg+2 of more than 0.07 mmol/L. Serum and whole cell Mg+2 correlation was linear (r = 0.9181, p < 0.0001). All 6 patients complained of muscle cramping at enrolment; 5 reported an improvement or complete resolution by week 3. Serum aldosterone levels were high at the start in 4 and reduced in 3. Urine magnesium concentration increased in 2. Conclusions: A topical magnesium chloride hexahydrate spray maintains or improves serum magnesium levels in patients with an ileostomy and hypomagnesaemia and prevents muscle cramps. Clinical trial number: RD13–045

Keywords

• Ileostomy
• Jejunostomy
• Short bowel
• Hypomagnesaemia
• Magnesium chloride hexahydrate spray
• High output stoma