Bromelain - Therapeutic indications

By Dr. Rita Fabbri

Sports injuries

Bromelain is indicated in the treatment of various sports injuries such as in the case of direct trauma (contusions) and indirect trauma (contractures, strains and tears).
It is important to note that the demonstrated pain-reducing effect is most likely due to Bromelain's ability to reduce tissue inflammation and edema, rather than a direct analgesic effect.
The best known study dates back to 1960 and concerns boxing:

• 58 out of 74 boxers treated with Bromelain reported that the bruising had disappeared within 4-5 days; in the remaining 16, the disappearance had occurred in 8-10 days.

Bromelain also appears to be effective in improving muscle function after intense physical activity.

Respiratory disorders

Bromelain is a good mucolytic in respiratory tract disorders, in particular it has proved to be an excellent decongestant of the mucous membranes in case of acute catarrhal inflammation.

• Patients examined with a spirometer to determine respiratory function before and after treatment with bromelain showed an increase in lung capacity and function.These effects resulting from the improvement of respiratory congestion are due to the ability of Bromelain to thin and reduce bronchial secretions.

Promising results were obtained in an experimental model of acute allergic asthma induced by ovalbumin.
Acute sinusitis also responds to bromelain therapy.

• The efficacy of Bromelain in children with sinusitis was evaluated in a clinical study. 116 children (aged less than 11 years) were enrolled, treated with Bromelain alone or in combination with standard therapy for this disease, or with therapy alone. The evaluation parameter was the duration of symptoms. Bromelain alone was found to lead to the disappearance of symptoms after about 6 days compared to 7-8 days in patients treated with standard therapy and compared to 9 days in patients treated with Bromelain combined with standard therapy.

One patient developed a Bromelain allergy and dropped out of the study. No other adverse effects were recorded

Thrombophlebitis

Oral administration of Bromelain is effective on thrombophlebitis (34-35).

• In a double-blind study conducted on 73 patients with acute thrombophlebitis, it was shown that Bromelain, combined with analgesics, reduces symptoms of inflammation such as pain, edema, redness, elevated skin temperature, difficulty in movement. other studies, the average daily dose ranged from 60 to 160 mg of Bromelian from 1,200 mcu. According to some authors, doses of 400 to 800 mg would be needed to obtain consistent results in patients with thrombophlebitis and, more generally, in all applications clinics mentioned.

Varicose veins

Varicose veins (or varicose veins) are dilations of the leg veins characterized by a reduced fibrinolytic activity following a reduced level of the plasminogen activator: this can lead to the deposition of fibrin causing hardening and prominences in the surrounding tissues. Bromelain acts in a similar way to the plasminogen activator causing the splitting of fibrin.
Bromelain should be used before and after varicose vein surgery.

• In a study that looked at a series of 180 varicose vein operations, Bromelain was given to 90 patients at 40 mg four times a day, on the first to third postoperative day, and at a dose of 20 mg four times a day. from the fourth to the seventh day, as a preventive treatment for bruises and bruises. The number of bruises and bruises was significantly reduced in the treated group: after two weeks 65 out of 90 treated patients had no bruises while only 32 out of 90 untreated patients had no bruises.

Dysmenorrhea

Bromelain and papain have been used successfully in the treatment of dysmenorrhea (painful menstruation). Bromelain is thought to be a smooth muscle relaxant as there was a reduction in spasms of the contracted cervix in treated patients.

Antitumor activity

Bromelain can potentiate standard chemotherapy treatment.

• In a study conducted in Germany, oral administration of bromelain, sometimes given with sub-acute doses of chemotherapy drugs, such as 5-fluorouracil and vincristine, induced tumor regression. It has also been shown that doses of less than 100 mg per day of Bromelain are inactive; it seems that doses up to 2.4 g / day are needed to have optimal effects and that the most effective preparations are those that are not gastro-resistant. According to some authors, the therapeutic effect is due to the ability of Bromelain to “deconstruct” the fibrin barrier of tumor cells, facilitating the intervention of the immune system (40-41).
• In a study conducted in France, 12 patients with different types of cancer were treated with 600 mg per day of Bromelain for periods from six months to several years: in women with tumors in the ovaries and breast the tumor masses regressed compared to patients treated with standard therapy.

These results, confirmed by studies conducted at the Cancer Research Center (University of Honolulu), suggest that bromelain, in addition to increasing the efficacy of chemotherapy, could also exert anticancer activity (43-44).

Antibiotic activity

Bromelain appears to exert antibiotic effects; in fact it has been found to be effective in the treatment of various infectious processes such as pneumonia, perirectal abscesses, pyelonephritis, staphylococcal skin infections (45-47).

Cellulite and overweight

The stem of the pineapple is traditionally used in the treatment of cellulite. Generally when we talk about cellulite we think of a skin imperfection and not an inflammatory process that leads to the stagnation of liquids in the interstitial spaces; this phenomenon is associated with the deposit of fat in the tissue subcutaneous causes the morphological alterations characteristic of cellulite (orange peel skin and sore cellulite nodules). As we know cellulite manifests itself in various ways, in various parts of the body, and there are many causes, but we also know that the stem of the " By stimulating diuresis, restoring cell trophism and normalizing the structure of skin and subcutaneous tissue, pineapple can help in the prevention and treatment of cellulite (49-50). Precisely for these reasons, Pineapple is recommended for obese or overweight subjects, especially when water retention is the cause of the increase in body weight.

Wounds and burns

It has been shown that treatment with bromelain, in addition to a thorough cleaning of the lesion, also promotes the reduction of pain in human wounds and burns (51-52).

• In a study conducted on 130 patients with second and third stage burns, a preparation containing Bromelain was applied for 4 hours in occlusion by means of a patch. The percentage of necrotic tissue removal - which could compromise wound healing - was 89% after each single application, 77% after two applications and 62% after the third.

Other clinical applications

Bromelain has shown excellent results in chronic lichenoid pityriasis.
Lichenoid pityriasis is not a frequent disease (one case out of 1000-1500 new patients) and often affects the "pediatric age. It is a dermatitis not easily codified due to its often different clinical aspects, for the very variable duration (from a few weeks to a few years) and for the unpredictable course. The lesion starts from a small hard purpuric papule that evolves widening, flattening and becoming more brown; finally, above it, a scaly-crust appears; the lesions are almost asymptomatic in generally not itchy. The etiology of the disease is unclear. As for the treatment, attempts have been made with oral tetracyclines and erythromycin but have yielded inconsistent results; the application of local cortisone is generally not very effective (54-55).

• The efficacy of oral bromelain was evaluated in eight patients with chronic pityriasis lichenoid in a small clinical study. Complete clinical resolution occurred after three months of treatment.

Bromelain seems to exert a cardioprotective effect but the data is still only experimental.
The research project on the applicative potential of Bromelain in the case of autistic syndrome is particularly interesting.

Other articles on "Bromelain - Therapeutic Indications"

1. Pineapple and Bromelain - Therapeutic indications
2. Pineapple
3. Pineapple: Contraindications and Bibliography

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