Bromelain is a mixture of protein-digesting enzymes found in pineapples (Ananas comosus). Bromelain supplements contain active substances that aid digestion and help reduce inflammation.

Bromelain is useful in the treatment of a wide range of conditions, but it is particularly effective in relieving inflammation associated with infection and physical injuries.

Studies have shown that bromelain may help in the treatment of the following:

Surgical Procedures and Sports Injuries

Although studies show mixed results, bromelain supplements may reduce swelling, bruising, healing time, and pain following surgery and physical injuries. In fact an authoritative body in Germany called the Commission E (similar to the U.S. Food and Drug Administration) approved the use of bromelain for these purposes.

Wounds and Burns

Some studies of animals indicate that bromelain (applied to the surface of the skin) may be useful in removing dead tissue from third-degree burns (particularly burns that go through all layers of the skin). This application has not yet been tested on people, but traditional and current day practices in Japan, Hawaii and Taiwan include use of topical bromelain to clean wounds and burns. Similarly, some clinicians may recommend this topical agent to reduce swelling from insect bites or stings.

Nasal and Sinus Congestion

Although not all experts agree, bromelain supplements may help suppress cough, reduce nasal mucus associated with sinusitis, and relieve the swelling and inflammation caused by hay fever. Bromelain is approved by the German Commission E for the treatment of sinus and nasal swelling following ear, nose, and throat surgery or trauma.

Digestion

The protein-digesting enzymes found in bromelain help promote and maintain proper digestion and may relieve symptoms of stomach upset or heartburn, particularly when used in conjunction with other enzymes such as amylase (which digests starch) and lipase (which digests fat). Similarly, an animal study suggests that the antibacterial effects of bromelain may help to control diarrhea caused by bacteria. Studies in people are needed.

Arthritis and other Inflammatory Conditions

Bromelain supplements may be as effective as some commonly used nonsteroidal anti-inflammatory (NSAID) medications (such as ibuprofen and diclofenac) for reducing pain associated with osteoarthritis. Similarly, preliminary studies suggest that bromelain may also help reduce the pain associated with rheumatoid arthritis. Plus, long-standing use of bromelain suggests that this enzyme may be helpful as part of the treatment for other connective tissue disorders including scleroderma (build up of tough scar-like tissue in the skin and, at times, internal organs), bursitis, and tendinitis.

Infection

Some scientific evidence from test tubes and animals suggests that bromelain can fight against infectious agents such as viruses and bacteria. Therefore, bromelain may prove a useful addition to conventional treatment of bronchitis, pneumonia, and urinary tract infections. More research is needed.

Amyloidosis

Amyloid is a protein-like substance that can build up and cause damage to many organs in the body such as the kidneys, liver, or heart. This build-up of amyloid is called amyloidosis. In one laboratory study, researchers examined the tissue of one person with a strong family history of amyloidosis. They found that bromelain may help breakdown amyloid deposits in kidney tissue. This very preliminary finding does not indicate how this information will translate to treatment or prevention of amyloidosis for people in general. Much more research is needed.

Bromelain is found in the common pineapple plant.

Bromelain is available in tablet or capsule form for oral use. It may also be used topically to treat severe burns.

Pediatric

There are no known scientific reports on the pediatric use of bromelain. Therefore, use of this supplement is not currently recommended for children.

Adults

The German Commission E recommends 80 to 320 mg two to three times per day. For specific conditions, higher doses may be prescribed as follows:

• Digestive aid: 500 mg per day in divided doses with meals
• Traumatic injuries: 500 mg four times a day on an empty stomach
• Joint inflammation: 500 to 2,000 mg a day in two divided doses

Because supplements may have side effects or interact with medications, they should be taken only under the supervision of a knowledgeable healthcare provider. Bromelain is generally recommended for no longer than 8 to 10 days in a row.

Possible side effects from bromelain include nausea, vomiting, diarrhea, and excessive menstrual bleeding.

Individuals who are allergic to pineapples should not use bromelain supplements because skin reactions and/or asthma-like symptoms may occur.

Pregnant women and individuals with bleeding disorders, high blood pressure, and liver or kidney disease should consult a healthcare provider before taking bromelain.

If you are currently being treated with any of the following medications, you should not use bromelain without first talking to your healthcare provider.

Antibiotics
In a clinical study, the combination of bromelain and amoxicillin increased the levels of this antibiotic in the blood. Some studies suggest that bromelain may increase the body's ability to absorb tetracycline, but results of other studies have been conflicting. Until studies confirm these results, it would be wise to avoid combining bromelain and tetracycline.

Studies with bromelain and tetracycline have produced mixed results. Some research suggests that bromelain increases levels of tetracycline in the body, while others indicate that it may cause more of the antibiotic to be excreted in the urine.

Blood-thinning Medications
People taking aspirin, warfarin, or other medications that thin the blood should use bromelain with extreme caution because of a possible risk of bleeding when used together.

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