Bromelain: benefits, side effects and medications

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Bromelain is a blend of enzymes found naturally in the juice and stems of pineapple ( Ananas comosus ). Available in dietary supplement form, bromelain is considered a proteolytic enzyme, a class of enzymes believed to aid in the digestion of proteins. Bromelain supplements are believed to treat a variety of health conditions, especially those associated with chronic inflammation, such as allergies , osteoarthritis , sinusitis , and ulcerative colitis .

Bromelain is also believed to stimulate digestion and improve heart health , in addition to protecting against certain forms of cancer. The medicinal qualities of pineapple are recognized in many traditions in South America, China, and Southeast Asia.

Get Medication Information / Gary Foerster

Health benefits

According to the National Center for Complementary and Integrative Health (NCCIH), the best evidence for bromelain is relief of symptoms of acute nasal and sinus inflammation when used in combination with standard medications.

Research on other benefits of using bromelain is conflicting (osteoarthritis and muscle pain after exercise) or non-existent (cancer and gastrointestinal problems).

Here are some of the findings from the available research on the potential health benefits of bromelain:

Sinusitis

Numerous studies have documented the benefits of bromelain for sinusitis. In a 1967 double-blind study , 60 patients with moderate to severe sinusitis received bromelain or placebo along with standard therapy for six days. The researchers found that inflammation decreased in 83 percent of the bromelain patients compared to just over half in the placebo group, and breathing difficulties decreased by 78 percent in the bromelain group compared to the 68 percent in the placebo group.

More recently, a 2006 review of 10 randomized controlled trials found that when used with standard medications, bromelain can help relieve sinus inflammation. A pilot study of 12 chronic sinusitis patients, published in 2013, found that taking 500 milligrams of bromelain six times a day for three months improved symptoms and quality of life. Finally, a review of a 2016 review of studies found that bromelain can shorten the duration of acute sinusitis symptoms in children , improve breathing, and reduce nasal inflammation.

Analgesic

Laboratory studies show that bromelain reduces the levels of certain substances that cause inflammation in arthritis, but results from clinical trials are mixed. Studies investigating bromelain for pain relief after episiotomy (surgical incisions of the perineum) during labor have also shown mixed results.

Bromelain provides relief in nose and foot surgery, although the research is dated, as well as dental surgery.

Knee pain

So far, studies looking at the effects of bromelain on knee pain have produced mixed results. For example, in a small study published in QJM: Monthly Journal of the Association of Physitors in 2006, bromelain supplements were no more effective than placebo in relieving symptoms such as pain and stiffness in people with knee osteoarthritis. The 12-week study enrolled 47 patients with moderate to severe knee osteoarthritis.

In contrast, in a 2006 review published in the journal Arthritis Research & Therapy , researchers looked at nine clinical trials using bromelain to treat osteoarthritis pain. Seven of these studies found that bromelain is as effective as diclofenac, a non-steroidal anti-inflammatory drug often prescribed for osteoarthritis, while two other studies found that bromelain is no more effective than placebo.

Other research suggests that bromelain can relieve knee pain in people without arthritis. This includes a small study published in the journal Phytomedicine in 2002. Analyzing data from 77 healthy adults with mild acute knee pain, the study authors found that one month of bromelain treatment significantly improved symptoms and improved physical function.

Surgical pain

Oral bromelain has been found to be effective in reducing pain, swelling, and healing time after surgery. However, its effect has been found to differ in different people and different tissues in the same person.

When bromelain was prescribed to 40 patients after maxillofacial surgery in a 2016 study , 70 percent of the patients experienced reductions in swelling and pain. Researchers have recommended a daily dose of 750 to 1,000 milligrams per day in divided doses to be taken before meals.

Inflammatory bowel disease

A study in mice, published in the journal Clinical Immunology in 2005, shows that bromelain can help treat inflammatory bowel disease (IBD). Research has shown that bromelain can help suppress inflammation associated with IBD.

In another study published in 2008, researchers exposed colon biopsies from patients with ulcerative colitis and Crohn's disease to bromelain. They reported that bromelain reduces the production of several pro-inflammatory cytokines and chemokines (cell signaling proteins) that are elevated in IBD and play a role in its progression.

There are reports of two ulcerative colitis patients who responded well to bromelain treatment, but bromelain has not been extensively tested in animals or humans with IBD. More research is needed to see if similar changes also occur when colon tissue is exposed to bromelain within the body.

Asthma

According to preliminary research published in the journal Alternative Therapies in Healthcare and Medicine in 2012, bromelain shows promise for treating asthma. In tests on mice, the researchers observed that bromelain treatment could suppress airway inflammation associated with asthma.

Cancer

Some preliminary research suggests that bromelain may have cancer-fighting properties, but these effects have not been confirmed in humans. For example, in a study published in the Journal of Medicinal Food in 2012, tests on breast cancer cells showed that bromelain could fight breast cancer by inducing apoptosis, a type of programmed cell death necessary to stop proliferation. cancer cells.

In a 2007 study, bromelain treatment increased the survival rate of animals with leukemia, lungs, chest, sarcoma (bone and soft tissue), and ascetic tumors.

According to the Memorial Cancer Center. Sloan Kettering, can be useful as an adjunct in the treatment of cancer.

Wound healing

Bromelain has been investigated for its cleansing effect on burns. A review of clinical evidence has shown that topical bromelain preparations can help remove dead skin from burns. However, there is insufficient evidence to show whether topical bromelain helps heal specific wounds.

Preparations and dosage

Eating a lot of pineapple will not have the same effect as taking a bromelain supplement. Bromelain is mainly found in the stem of pineapple, which is generally not eaten.

Bromelain supplements are sold as powders, creams, tablets, or capsules that can be used alone or in combination with other ingredients.

There is no standard dosage for bromelain. It is often recommended to take 200 to 400 mg three times a day on an empty stomach. For children, cut this dose in half.

When used as a digestive aid, bromelain is generally taken with food. In inflammatory conditions, it is often taken between meals on an empty stomach to maximize absorption.

Possible side effects.

Side effects commonly associated with bromelain include abnormal uterine bleeding, diarrhea, drowsiness, heavy periods, palpitations, upset stomach, nausea, and vomiting.

In some people, bromelain can cause allergic reactions and asthma symptoms such as breathing problems, tight throat, hives, rashes, and itchy skin.

Contraindications

People with allergies to pineapple should avoid using bromelain. Allergic reactions can also occur in people allergic to latex, carrots, celery, fennel, rye, wheat, papain, bee venom, or grass, birch, or cypress pollen.

Also, bromelain is contraindicated in pregnant women and people with peptic ulcers. People with other digestive disorders should check with their healthcare provider before taking bromelain supplements.

Bromelain can increase the risk of bleeding and should also be avoided before surgery. Bromelain can be harmful to people with bleeding disorders and people taking blood-thinning (blood-thinning or antiplatelet) medications or supplements such as aspirin, Coumadin ( warfarin ), or ginkgo biloba.

It should also be noted that avoiding or delaying standard treatment and self-treating a chronic condition with bromelain supplements can have serious consequences. Talk to your doctor if you are considering using bromelain to treat any medical conditions.

Frequently asked questions

  • Bromelain is marketed as a supplement to reduce pain, swelling, and inflammation, for example, in the nose, sinuses, and gums. It is also believed to help with burns, osteoarthritis, cancer, muscle pain, and digestive problems, but there is insufficient evidence to determine if it is effective.

  • There may be some risks, so check with your doctor before taking it. You should not take it if you are pregnant, nursing, have a peptic ulcer, or a bleeding disorder. Bromelain can interact with other medications such as antibiotics and blood thinners. You should also avoid bromelain if you are allergic to pineapple or other substances such as latex, rye, wheat, carrots, celery, fennel, or certain types of pollen.

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