Introduction
Bromelain has anti-inflammatory and anticoagulant effects. It stands for a group of protein-degrading enzymes of certain plants. These particular enzymes are found in the pineapple plant, among others.
Therefore, it is also included in the group of so-called phytotherapeutics, which are also known as herbal medicinal products. Bromelain is used by its specific effects to treat inflammation or injuries associated with swelling. It is also used in the treatment of oedema. Bromelain is available in pharmacies under the trade names Bromelain-POS©, Wobenzym© or Traumanase©.
Application and dosage
The most common form of application of the drug bromelain is the so-called enteric tablet. Bromelain can also be purchased in the form of sugar-coated tablets. It is available in pharmacies, but not on prescription, so you can buy it for free in the pharmacy.
The tablets pass through the stomach through a special protective film without already being broken down by the stomach acid. This is necessary because gastric acid in particular already digests proteins from food in the stomach. It is therefore important that the active ingredient is only released in the intestinal area and can therefore be absorbed by the blood, otherwise it will be digested and thus lose its effect.
The use of bromelain is only permitted for adults and adolescents aged 12 years and older. Therefore, there is a contraindication to the use of bromelain for children under 12 years of age. The tablet should be taken about 30 minutes apart from a meal with plenty of liquid.
Bromelain should be taken as a tablet once or twice a day. It should not be taken for more than four to five days without medical advice. A doctor should be consulted for longer treatment.
Intoxications are not known to occur with the administration of bromelain. However, an overdose may increase the occurrence of side effects. Due to the anti-inflammatory and decongestant effect of bromelain, it can be used in various diseases.
Among other things, it can be used for post-operative swelling or for swelling caused by injuries. Bromelain can also be used for non-bacterial swelling of the mucous membrane. In cases of insufficient production and availability of digestive enzymes, for example in the context of a pancreatic disease, the administration of bromelain can be helpful.
It can also be used for inflammation of the paranasal sinuses or the urinary tract and sexual organs. Bromelain can also be taken for venous diseases or for pelvic and leg vein thrombosis and arthrosis. In higher concentrations it also has a draining effect on the human body, so that it can also be used to treat oedema.
The main effect of bromelain is an anti-inflammatory, decongestant effect. For this reason, the active ingredient is often used in sinusitis, where it often achieves good treatment results. The effect is based on the splitting of the body’s own tissue hormone bradykinin.
This is responsible for dilating the small blood vessels. If the bradykinin is now split by the enzymes contained in the bromelain, the blood vessels in the paranasal sinuses constrict and less fluid passes from the vessels into the surrounding tissue – the swelling decreases. However, the mechanism underlying the anti-inflammatory effect of bromelain has not yet been clarified.
It is important to take bromelain at least 30-60 minutes before meals in order to develop its effectiveness. Due to its decongestant and anti-inflammatory effect, bromelain can also be used before and after surgery. Before the operation, for example, it can help to combat joint swelling and thus create the necessary conditions for the operation.
After the operation, bromelain helps to reduce swelling in the operating area and also prevents the development of inflammation. However, a pain-relieving effect is not yet known for bromelain, which means that other active substances must be used for this aspect of post-operative treatment. Bromelain, like practically all drugs, can trigger allergic reactions.
These usually manifest themselves in the form of skin rashes and tingling in the mouth area. Although these are usually harmless and disappear on their own after a few days, in rare cases they can also be precursors of more serious forms of the disease and should therefore be referred to the doctor treating the patient as soon as possible. Bromelain is also used in the food industry to clarify beer and in the processing of meat.
For this reason, bromelain should be considered as a possible trigger of food allergies. The use of bromelain is contraindicated in cases of hypersensitivity to the active substance and hypersensitivity to pineapple. Patients with blood coagulation disorders should also refrain from taking the drug bromelain.
A simultaneous intake with the so-called blood thinners such as Marcumar, Heparin or similar substances should be avoided. The drug is not suitable for children or adolescents under the age of 12. There are no data available for the use of bromelain during pregnancy, so it is not recommended to take it during pregnancy.
Bromelain should also not be taken while breast-feeding, as it is not known whether its components pass into breast milk and thus reach the infant. Although no specific adverse effects of long-term use of bromelain have been identified, the same should apply as always: as much as necessary, as little as possible. Therefore, bromelain therapy should initially be limited to 5 to a maximum of 7 days.
If there is no noticeable improvement in the situation after this period, the treating physician should be consulted again. The doctor can then decide whether continuing bromelain therapy promises success or whether switching to a different active substance makes more sense. To date, no data are available on the tolerance of bromelain in pregnancy.
As a risk to the mother and child cannot be excluded, it is not advisable to take bromelain during pregnancy. The same applies to breastfeeding: here too, it is not known whether the drug can be transmitted via breast milk and whether, in this case, it can harm the child. Consequently, the use of bromelain should also be avoided during the breastfeeding period.
