Bromelain is an extract of pineapple which has natural anti-inflammatory effects. Therefore it is frequently used to treat minor injuries, sports injuries, and to help healing after surgery or trauma. Dosage: The German Commission E recommends 80-320 mg two to three times per day. As  digestive aid, the recommended dosage is generally 500 mg three times per day. Inflammation; 500-mg to 2,000-mg per day. For best results, the total daily dosage should be divided into 4 doses and taken an hour before or after food. Bromelain has to be enteric-coated so that it will not be used as a digestive enzyme if activated in the stomach. When taken on an empty stomach approximately 40% of the bromelain is absorbed into the bloodstream intact.

Bromelain and Inflammation

Bromelain is frequently used to lessen inflammation from with tendonitis, sprains and strains, and other minor muscle injuries. Bromelain, has been used by Europeans for many years to inhibit inflammatory factors. Bromelain enzyme inhibits formation of prostaglandin E-2, a chemical that causes inflammation, and it also helps to stimulate the production of prostaglandin E-1, an anti-inflammatory chemical. Bromelain enzyme works by blocking selected proinflammatory metabolites that accelerate the inflammatory process. In animal studies, bromelain was the most powerful of nine substances examined, on a par with the drug prednisone. The German Commission E (an official government agency similar to the FDA) approved bromelain to treat swelling and inflammation after surgery, especially sinus surgery.

Clinical studies have evaluated the effectiveness of  bromelain most frequently using preparations containing differing complexes of proteolytic enzymes and differing concentrations of  bromelain. 1- Phlogenzyme, which contains the proteolytic enzymes bromelain, rutin and; trypsin, 2- Wobenzyme which contains bromelain, trypsin, papain, chymotrypsin, pancreatin, amylase and lipase; and 3- Wobenzym N which contains bromelain, rutin, trypsin, papain, pancreatin and chymotrypsin. One study showed that a combination of bromelain, trypsin and rutosid (Phlogenzym) worked as well as nonsteroidal anti-inflammatory medications, which are commonly used pain relievers, for reducing knee pain from osteoarthritis. In a study from Germany, scientists divided 90 participants with painful osteoarthritis of the hip into 2 groups; : one half receiving an oral enzyme preparation containing bromelainn for 6 weeks, while the other half received the anti-inflammatory medication diclofenac. They found that the bromelain was as powerful as diclofenac in standard scales of pain, stiffness and physical function, and better tolerated than the medication comparator. In another study, comparing a supplement containing bromelain with diclofenac reached the similar conclusion. The study reported that the preparation containing bromelain  to be as efficacious as diclofenac in improving the symptoms of osteoarthritis of the knee. Participants reported comparable reductions in joint tenderness, pain and swelling, and healing in range of motion at the end of the study. The findings, reported in Phytomedicine in 2002 demonstrated that a combination of  bromelain, rutosid, and trypsin significantly improved scores on the WOMAC knee health index in subjects. The results of a study that included 103 people with osteoarthritis of the knee, reported in the Oct 2004 edition of  Clinical Rheumatology, show that bromelain may be as effective as NSAIDs (nonsteroidal anti-inflammatory drugs).

Bromelain may offer strong support for healing and pain relief after surgery. Researchers administered a combination of bromelain, rutin, and trypsin, to patients for 2 weeks following surgery to fix fractured long bones. Compared with surgical patients who did not receive the supplement, the bromelain-treated group demonstrated a important diminution in postoperative swelling. A study reported in the July 1995 edition of  “Fortschritte der Medizin” found 59 people treated with bromelain over a 3 week period had reduction in swelling, pain and tenderness.

Other possible use of bromelain is in treating IBD (inflammatory bowel disease). In vitro studies demonstrate that bromelain might decrease the inflammatory molecules generated by biopsy-obtained colonic cells obtained from patients with inflammatory bowel disease. Treating these colonic cells with bromelain decreased the secretion of a variety of  proinflammatory molecules including colonystimulating factor and interferon-gamma. The bromelain may  alleviate inflammation in digestive disorders, such as Crohn’s disease  and ulcerative colitis, according to a study reported in the 2008 edition of  Clinical Immunology. Orally administered bromelain was anecdotally reported to induce clinical and endoscopic remission of ulcerative colitis in 2 patients whose disease was refractory to multi-agent standard medical treatment.