Ananas comosus, Ananas sativus, Ananase®, Bromelain-POS, bromeline (pleural), Bromelainum, Bromeliaceae (family), Bromelin, Bromelins, Debridase, Phlogenzym (rutoside, bromelain, and trypsin), enzyme-rutosid combination, ERC (rutosid, bromelain, trypsin), plant protease concentrate, pineapple, pineapple extract, rutosid, Traumanase®, trypsin.
Classified as an herb, bromelain is a sulfur-containing proteolytic digestive enzyme that is extracted from the stem and the fruit of the pineapple plant (Ananas comosus, family Bromeliaceae).
When taken with meals, bromelain is believed to assist in the digestion of proteins. When taken on an empty stomach, it is believed to act medicinally as an anti-inflammatory agent.
The expert panel, the German Commission E, approved bromelain for the treatment of swelling/inflammation of the nose and sinuses caused by injuries and surgery in 1993.
Several preliminary studies suggest that when taken by mouth, bromelain can reduce inflammation or pain caused by inflammation. Better quality studies are needed to confirm these results.
Sinusitis (sinus inflammation):
It is proposed that bromelain may be a useful addition to other therapies used for sinusitis (such as antibiotics) due to its ability to reduce inflammation/swelling. Studies report mixed results, although overall bromelain appears to be beneficial for reducing swelling and improving breathing. Better studies are needed before a strong recommendation can be made.
A bromelain-derived debriding agent, Debridase, has been studied on deep second degree and third degree burns with positive results. Further results are needed to confirm these results.
There is not enough information to recommend for or against the use of bromelain in the treatment of cancer, either alone or in addition to other therapies.
Digestive enzyme/pancreatic insufficiency:
Bromelain is an enzyme with the ability to digest proteins. However, there is little reliable scientific research on whether bromelain is helpful as a digestive aid. Better study is needed before a firm conclusion can be made.
There is not enough information to recommend for or against the use of bromelain as a nutritional supplement.
There is conflicting evidence on the effectiveness of bromelain to treat osteoarthritis. Further well-designed clinical trials of bromelain alone are needed to confirm these results.
Bromelain may help treat this type of skin rash. This treatment may be effective because bromelain has been shown to decrease inflammation, regulate the immune system, and have antiviral effects.
Rheumatoid arthritis (RA):
There is not enough information to recommend for or against the use of bromelain in rheumatoid arthritis (RA).
Steatorrhea (fatty stools due to poor digestion):
There is not enough information to recommend for or against the use of bromelain in the treatment of steatorrhea.
A variety of doses have been used and studied. Research in the 1960s and 1970s used 120 to 240 milligrams of bromelain concentrate tablets daily (Traumanase® or Ananase®; 2,500 Rorer units per milligram) in three to four divided doses for up to one week to treat inflammation. The German expert panel, the Commission E, has recommended 80 to 320 milligrams (200 to 800 FIP units) taken two to three times per day. Some authors recommend 500 to 1,000 milligrams of bromelain to be taken three times daily, and many manufacturers sell products standardized to 2,000 GDU in 500 milligram tablets. Effects of bromelain may occur at lower doses, and treatment may be started at a low dose and increased as needed.
Cream containing 35% bromelain in an oil-containing base has been applied to the skin to clean wounds.
There is not enough scientific research to recommend safe use of bromelain in children.
There are multiple reports of allergic and asthmatic reactions to bromelain products, including throat swelling and difficulty breathing. Allergic reactions to bromelain may occur in individuals allergic to pineapples or other members of the Bromeliaceae family, and in people who are sensitive/allergic to honeybee venom, latex, birch pollen, carrot, celery, fennel, cypress pollen, grass pollen, papain, rye flour, or wheat flour.
Few serious side effects have been reported with the use of bromelain. The most common side effects reported are stomach upset and diarrhea. Other reported reactions include increased heart rate, nausea, vomiting, irritation of mucus membranes, and menstrual problems.
In theory, bromelain may increase the risk of bleeding. Caution is advised in people who have bleeding disorders or who are taking drugs that increase the risk of bleeding. Dosing adjustments may be necessary. Bromelain should be used with caution in people with stomach ulcers, active bleeding, a history of bleeding, taking medications that thin the blood, or prior to some dental or surgical procedures.
Bromelain may increase heart rate at higher doses and should be used cautiously in people with heart disease. Some experts warn against bromelain use by people with liver or kidney disease, although there is limited scientific information in these areas. Bromelain may cause abnormal uterine bleeding or heavy/prolonged menstruation.
Bromelain is not recommended during pregnancy or breastfeeding, as little safety information is available. Bromelain may cause abnormal uterine bleeding.