This article aims to review the current literature on the therapeutic applications of bromelain, including its anti-inflammatory, analgesic, and digestive benefits, as well as its potential effects on various medical conditions. 

Bromelain, a proteolytic enzyme derived from the pineapple stem (Ananas comosus), has garnered attention in the medical community for its numerous therapeutic effects. Research suggests that bromelain may be effective in treating conditions such as osteoarthritis, sinusitis, and postoperative swelling. This article will also discuss the mechanisms of action, safety profile, and potential drug interactions of bromelain.

Bromelain is a mixture of enzymes extracted from the pineapple plant, primarily from the stem and fruit. Historically, bromelain has been used in folk medicine, but recent studies have illuminated its potential therapeutic benefits.

Mechanism of Action

Bromelain exhibits several biological activities, primarily attributed to its proteolytic properties. It catalyzes the breakdown of protein molecules, facilitating the digestion of proteins in the gastrointestinal tract. Furthermore, bromelain exhibits anti-inflammatory and analgesic effects by modulating immune responses and acting on signalling pathways involved in pain and inflammation [1].

Therapeutic Applications

Anti-Inflammatory Effects

Numerous studies indicate that bromelain significantly reduces inflammation. Its efficacy has been demonstrated in conditions such as osteoarthritis, where it may alleviate joint swelling and pain [2]. A double-blind placebo-controlled trial showed that patients taking bromelain experienced significant reductions in pain and improved joint function compared to the placebo group [3].

Analgesic Properties

Bromelain's analgesic effects have been observed in postoperative pain management. Research has indicated that bromelain can reduce swelling and alleviate pain following oral surgery and fracture presentations [4]. It may serve as an adjunctive treatment to traditional analgesics, minimising the need for opioids [5].

Digestive Health

As a proteolytic enzyme, bromelain aids in protein digestion, potentially benefiting individuals with pancreatic insufficiency. Some studies suggest that bromelain may help with digestive disorders, such as indigestion and bloating, by enhancing protein absorption [6].

Sinusitis Treatment

Bromelain has been studied for its effectiveness in treating sinusitis. Clinical trials have shown that bromelain can reduce nasal swelling and improve mucus drainage, providing relief from sinus congestion [7].

Potential in Cancer Therapy

Emerging research indicates bromelain's potential role as an adjunct in cancer treatment. Studies have suggested that bromelain may enhance the efficacy of chemotherapy and reduce its side effects [8]. However, further investigation is needed to establish its safety and effectiveness in oncological applications.

Safety and Drug Interactions

Bromelain is generally regarded as safe for most individuals; however, some adverse effects have been reported, including gastrointestinal discomfort, diarrhoea, and allergic reactions [9]. Patients taking blood thinners, antibiotics, or certain sedatives should consult healthcare providers before using bromelain, as it may enhance the effects of these medications [10].

Disclaimer- The views and opinions expressed in this article are those of the author and do not necessarily reflect the official policy or position of M3 India.

About the author of this article: Dr Partha Ghosh, BNYS, MD(YS), is a general physician and a medical writer from Siliguri, Darjeeling.