Costochondritis

Description

Bromelain, also known as bromelin, is a protein-digesting enzyme extracted from the flesh and stem of the pineapple plant, Ananas comosus. Although the people of Guadeloupe introduced Christopher Columbus to the fruit in 1493, Europeans did not recognize the pineapple's beneficial attributes until later. Pineapple had a long history of traditional use among the native peoples of Central and South America. They applied pineapple dressings to wounds and skin injuries to reduce inflammation, and eased stomachaches and indigestion by drinking the juice of the fruit.

Bromelain was first isolated from pineapple juice in 1891 and introduced as a therapeutic supplement in 1957. The active ingredients of bromelain are found in the juice and stem of the pineapple plant, but the stem contains more bromelain than the fruit.

General use

Bromelain is most notable for its effectiveness in the reduction of inflammation and decreasing swelling, but the scope of its benefits continues to increase. As a natural anti-inflammatory enzyme, bromelain has many uses. Arthritis patients may reduce the swelling that causes joint pain by taking bromelain. Bromelain may also be helpful for the pain, numbness, tingling, aching, and loss of motor and sensory function in the fingers resulting from carpal tunnel syndrome (CTS).

The protease enzyme is beneficial in reducing the clumping of platelets (small platelike bodies in the blood), the formation of plaques in the arteries, and the formation of blood clots . All these effects help to prevent and treat cardiovascular disease. Bromelain has also been discovered to have anti-tumor action, as well as helping the body absorb medications.

Although bromelain is often labeled an alternative treatment, mainstream medical research continues to study its effectiveness in the prevention and treatment of hematomas, or localized blood clots. Bromelain has been found useful in the reduction of swelling and congestion in the affected tissue after an athletic injury or surgery. It is commonly used in Germany for this purpose.

Bromelain's anti-clotting activity may be useful in preventing strokes, one of the most feared results of obstructions in the circulatory system. Due to the lack of oxygenated blood flowing to the brain, a stroke can cause permanent damage to the affected area of the central nervous system. Bromelain is thought to help maintain healthy cardiac tissue and reduce the risk of stroke by its anti-inflammatory activity. By preventing mild infection or inflammation caused by the fatty substances inside the blood vessels where plaque may form, bromelain helps to reduce inflammation by digesting the byproducts of tissue repair.

Bromelain is helpful to people with colds due to its ability to reduce mucus and keep it moving out of the body. Bromelain has also been shown to reduce the painful inflammation associated with costochondritis, an inflammation of the cartilage that attaches the ribs to the breastbone. In addition, bromelain appears to be beneficial to asthma patients. Asthma is caused by spasms of the bronchial passages that restrict the flow of air in and out of the lungs. Taking bromelain may reduce the excess mucus that tends to collect in the respiratory systems of asthma patients. In addition, people who suffer from hay fever and similar seasonal allergies may also be helped by bromelain's antiinflammatory activity.

Additional benefits of bromelain include reducing the painful symptoms of varicose veins , including dull aches, tired legs and feet, and itchy skin.

Research has also shown that bromelain benefits cows as well as humans. Bromelain has been shown to reduce the white blood cell count in cows with mastitis. This reduction increases the quality of their milk. Researchers have found that bromelain works to reduce inflammation by interfering with the synthesis of prostaglandins and other inflammatory substances.

Preparations

Bromelain is available as a dietary supplement that is offered in several different tablet strengths. For rheumatoid arthritis , the recommended dosage of bromelain is 250-750 mg, taken two or three times a day between or before meals. In Germany, the standard dosage to reduce swelling after surgery is 80-320 mg daily. The supplement has found to offer the most benefit when taken on an empty stomach, and its therapeutic effects are also enhanced when taken in higher doses.

Increasing the dosage of bromelain to 400-1,000 mg per day has shown to reduce the symptoms of angina pectoris (the severe pain and feeling of constriction about the heart that often radiates to the left shoulder and down the left arm).

Precautions

Bromelain has shown to be generally safe when taken in moderate doses, although a preliminary report links an increased heart rate with the use of the supplement. People with an inflammation of the stomach lining should not use digestive enzyme supplements such as bromelain. In addition, the safe use of bromelain in pregnant or nursing women, small children, and people with kidney or liver disease has not been established.

Side effects

While bromelain can be taken safely without side effects in moderate doses, there are anecdotal reports of allergic reactions to it. Other side effects that have been observed include nausea, vomiting, diarrhea, and menorrhagia (excessively heavy menstrual flow).

Interactions

Because of bromelain's anti-clotting activity, it should not be combined with other blood-thinning medications, such as warfarin (Coumadin), heparin, or aspirin. It is also possible that bromelain could cause problems with bleeding if it is combined with other complementary therapies that thin the blood, such as garlic or gingko biloba.

Key Terms

Mastitis

Inflammation of the breast.

Menorrhagia

Excessive bleeding at the time of a menstrual period, either in amount of blood or number of days, of both.

Plaque

An abnormal hardened deposit on the inner wall of an artery.

Protease enzyme

Any of a group of enzymes that help to break down proteins into smaller amino acid compounds. Bromelain belongs to this enzyme group.

Further Reading

For Your Information

Periodicals

• Petry, Judy J. "Nutritional supplements and surgical patients." AORN Journal (June 1997).
• Kelly, G.S. "Bromelain: A Literature Review and Discussion of Its Therapeutic Applications." Alternative Medicine Review (November 1, 1996).

Organizations

• American Botanical Council. PO Box 201660. Austin, TX 78720-1660.

Other

• HealthWorld Online. http://www.healthy.net (January 17, 2001).

Gale Encyclopedia of Alternative Medicine. Gale Group, 2001.